静注加肌注曲马多防治硬膜外麻醉期间寒战反应的研究

目的　观察曲马多防治硬膜外麻醉期间寒战反应时两种用药方法的临床效果。　方法硬膜外麻醉手术期间发生寒战的 6 0例成年患者 ,当出现寒战分级达 2～ 3级时 ,用室温下盐酸曲马多 1mg kg加氟哌啶 2 .5mg缓慢静脉推注 ,随机分成二组 :研究组 (R组 )与对照组 (C组 ) ,每组各 30例 ;R组在 5min内用上述同样药物和剂量予以肌内注射 ,C组以生理盐水 2ml肌内注射。观察寒战的治疗效果及 6h内寒战复发率。　结果　两组均于静注曲马多后 3min内起效 ,所有病人寒战反应均得到缓解 ,6h内R组均无寒战反应复发 ,C组有 5例再次出现寒战达 2级以上 ,给予追加首次量的 1 2后缓解 ,两组间差异有显著性 (P <0 .0 5 )。　结论　静注加肌注曲马多和氟哌啶可更有效地防治硬膜外麻醉期间的寒战反应。

Study of Therapeutic and Prophylactic Effects of Tramadol Intramuscular and Intravenous Injection on Shivering during Epidural Anesthesia

Objective To study the clinical therapeutic and prophylactic effects of tramadol intramuscular and intravenous injection on shivering during epidural anesthesia. Methods 60 adult patients suffered shivering under epidural anesthesia were randomly divided into two groups:group R(n=30) and group C (n=30). All patients were injected intravenously with tramadol 1mg per kg and droperidole 2.5 mg 5 minutes later, patients in group R received intramuscular injection with the same doses of above drugs, while same volume of saline was given to the patients of group C. All patients were observed to find out whether the shivering recurred after the injections. Results 3 minutes after the intravenous injection with tramadol and droperidole, shivering in both group were released. Within 6 hours, shivering did not recurred in patients of group R, but did in 5 patients of group C ( P <0.05). Conclusion Intramuscular injection combined with intravenous injection of tramadol could help to treat and prevent shivering under epidural anesthesia.