右美托咪啶用于预防经尿道前列腺电切术中寒战反应的临床观察

目的 观察右美托咪啶用于预防经尿道前列腺电切术（TURP）中患者发生寒战反应的效果.方法 择期拟行TURP的患者120例,年龄56～ 82岁,ASA分级Ⅰ或Ⅱ级,采用随机数字表法,将其随机分为2组,每组60例.腰硬联合麻醉后D组采用静脉泵注右美托咪啶3μg·（kg·h）-1,10 min后调整输注速度为0.4μg·（kg·h）-1,术毕前30 min停止输注.C组则按相同方法泵注等量生理盐水.观察并记录两组患者泵注药物前及泵注后各时点心率（HR）、平均动脉压（MAP）、呼吸频率（RR）、血氧饱和度（SpO2）的变化;并观察寒战发生率和寒战程度分级等情况.结果 两组患者术中血流动力学及呼吸均保持平稳,比较差异无统计学意义（P＞0.05）;D组寒战反应发生率及寒战程度分级均明显低于C组（P＜0.05）.结论 右美托咪定可安全、有效地预防经尿道前列腺电切术中寒战反应的发生.

Clinical observation of dexmedetomidine for the prevention of shivering reaction in transurethral resection of the prostate

Objectives To investigate the effect of dexmedetomidine for the prevention of shivering reaction in transurethral resection of the prostate（TURP）.Methods A total of 120 patients undergoing selective TURP,aged 56 to 82 years,ASA grade Ⅰ or Ⅱ,were randomly divided into two groups with 60 cases each.After combined spinal epidural anesthesia,group D received intravenous infusion of dexmedetomidine at the dose of 3 μg · （kg · h）-1 within 10 min and then 0.4μg · （kg · h）-1 until 30 min before the end of operation.Group C received intravenous infusion of equal volume of normal saline with same way.Changes of heart rate（HR）,mean arterial pressure （MAP）,respiratory rate（RR）,pulse oxygen saturation（Sp02） and occurrence rate and degree of shivering at each point were observed and recorded.Results There were no significant differences of hemodynamic and respiratory parameters at any time point between the two groups （P ＞ 0.05）.The rate of shivering occurrence and scores of shivering in group D were significantly lower than those of group C （P ＜ 0.05）.Conclusions Dexmedetomidine is deemed as safe,reliable and feasible to prevent the shivering reaction in TURP.