预先肌注曲马多对硬膜外麻醉后病人寒战的影响

目的 探讨肌肉注射曲马多对硬膜外麻醉后寒战的预防效果。方法 选择80例准备在硬膜外麻醉下行下腹、下肢或脊柱手术的成年患者，随机分为四组（每组20例）：肌注曲马多和氟哌利多组（TD组）；单纯曲马多组（T组）或氟哌利多组（D组）；对照组（C组）。于硬膜外注药前30分钟，TD组肌注曲马多1．5mg/kg和氟哌利多5mg;T组肌注曲马多1．5mg/kg；D组肌注氟哌利多5mg；C组不用药。观察麻醉及手术过程中寒战的发生率、寒战的严重程度及寒战发生前后体温变化。结果 寒战发生率TD组和T组均为5％，D组和C组分别为25％和35％，TD组和T组与C组比较差异显著（P＜0．05）。TD组哮睡发生率、T组恶心发生率较高。结论 肌注曲马多有助于预防低位硬膜外麻醉后寒战，应用时复合氟哌利多可减少曲马多的副作用。

Prophylactic effects of intramuscular injection of tramadol on shivering during epidural anesthesia in human

Objective To study the prophylactic effect of intramuscular injection of tramadol on shivering under epidural anesthesia.Methods 80 elderly patients operated on lower abdomen,lower limb and vertebral columu under epidural anesthesia,were randomly divided into four groups:group TD( n= 20),group T( n= 20),group D( n= 20) and the cointrol group(group C, n= 20).At 30min before epidural anesthesia,tramadol 1 5mg with droperidol 5mg was injected intramuscularly in group TD,tramadol 1 5mg/kg alone in group T,droperidol 5mg alone in group D,and no drugs in group C.The incidence rate and degree of shivering and the changes of body temperature before and after shivering were recorded during anesthesia.Results The incidence rate of shivering in group TD and group T was 5 percent,which was significantly lower than that in group D(25 percent) and group C(35 percent) respectively.Conclusion Intramuscular injection of tramadol could prevent shivering during epidural anesthesia,and droperidol may reduce some side effects of tramadol.