鞘内应用右美托咪定对腰麻下剖宫产病人寒战的影响
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Effects of intrathecal dexmedetomidine on shivering after spinal anesthesia for cesarean section: a double-blind randomized clinical trial.
背景与目的
背景寒战是腰麻（SA）常见的麻烦并发症之一，引起剖宫产产妇（CSs）不适及满意度下降。本研究旨在探讨鞘内应用右旋美托咪啶对SA下接受CS产妇寒战的预防作用。
方 法
50例拟在SA行CS的择期CSs被纳入这项前瞻性、双盲、对照研究中，并随机分为两组。0.5% 12.5mg重布比卡因+5μg右美托咪啶组(BD组),或0.5mL0.9%生理盐水组（BN组）。记录寒战的发生率和强度、外周和核心体温、血流动力学参数及不良事件。
结 果
BN组寒战发生率（52%）显著高于BD组（24%）（P＝0.04）。类似，BN组的寒战强度明显高于BD组(P=0.04)。两组患者出现低血压、恶心呕吐、心动过缓等不良事件的发生率无显著性差异，而BD组镇静程度高于BN组(p=0.004)
结 论
对SA下接受CS的产妇，鞘内应用右美托咪定能有效地降低寒战的发生率和强度而无重大不利影响。
原始文献摘要
Drug Des Devel Ther. 2017 Apr 3;11:1107-1113. doi: 10.2147/DDDT.S131866. eCollection 2017. Nasseri K, Ghadami N, Nouri B.
BACKGROUND:
Shivering is among the common troublesome complications of spinal anesthesia (SA), and causes discomfort and discontentment in parturients undergoing cesarean sections (CSs). The aim of this study was to investigate the effects of intrathecal dexmedetomidine in the prevention of shivering in those who underwent CS under SA.
SUBJECTS AND METHODS:
Fifty parturients planned for elective CSs under SA were enrolled in this prospective, double-blinded, controlled study and randomly divided into two equal groups. Spinal block was achieved with 12.5 mg 0.5% heavy bupivacaine plus 5 μg dexmedetomidine (BD group) or 0.5 mL 0.9% normal saline (BN group). The incidence and intensity of shivering, peripheral and core body temperature, hemodynamic parameters, and adverse events was recorded.
RESULTS:
The incidence of shivering was significantly higher in the BN group (52%) than the BD group (24%) (P=0.04). Likewise, the intensity of shivering was significantly higher in the BN group than the BD group (P=0.04). The incidence of adverse events, such as hypotension, nausea/vomiting, and bradycardia, was not significantly different between the two groups, although the grade of sedation was higher in the BD group than the BN group (P=0.004).
CONCLUSION:
We conclude that intrathecal dexmedetomidine is effective in lowering the incidence and intensity of shivering in parturients undergoing CSs under SA without major adverse effects.
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