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[肌内注射哌替啶预防脊髓麻醉时的寒战]

[Intramuscular meperidine for the prevention of shivering in spinal anesthesia].

作者信息

Hu L H, Chen J C, Lee Y, Lai K B, Wong K L, Wei T T

机构信息

Department of Anesthesiology, Chiau-Tun Yu-Min Hospital, Nan-Tou.

出版信息

Ma Zui Xue Za Zhi. 1992 Dec;30(4):223-8.

PMID:1344236
Abstract

Intravenous meperidine 25mg has been employed effectively to treat shivering following regional anesthesia and general anesthesia. The study was designed to evaluate the effectiveness of intramuscular meperidine for the prevention of shivering in spinal anesthesia. The series consisted of 60 patients who were divided into 2 groups with 30 patients in each, undergoing lower abdominal or lower extremity surgery. All patients were given diazepam 0.1mg/kg i.v. for anxiolysis when they came to the operating room. In a double blind and randomized fashion, patients in the study (meperidine) group received meperidine 25mg IM (= 0.5ml). In the control group 0.9% N/S 0.5ml IM was given instead. All patients received spinal anesthesia 15 minutes later. Measurement of the levels of sensory loss to pinprick was made. The ambient temperature and the rectal temperature were continuously monitored to evaluate the effect of the change in body temperature on shivering during operation. The degree and the occurrence of shivering were carefully evaluated and recorded by a blind-trust observer. There was no significant difference in maximal analgesic level, ambient temperature and change of rectal temperature during operation between the groups. Shivering occurred in 17 patients (56.7%) in the saline group with an onset time of 7.9 +/- 2.5min following spinal anesthesia. In the meperidine group, shivering occurred only in 3 patients (10%) with an onset time of 54 +/- 29.5min after spinal anesthesia. There was a significantly lower incidence of shivering in the meperidine group than in the saline group (p < 0.005).(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

静脉注射25毫克哌替啶已被有效地用于治疗区域麻醉和全身麻醉后的寒战。本研究旨在评估肌内注射哌替啶预防脊髓麻醉中寒战的效果。该系列研究包括60例患者,分为两组,每组30例,均接受下腹部或下肢手术。所有患者进入手术室时均静脉注射0.1mg/kg地西泮以进行抗焦虑治疗。采用双盲随机方式,研究组(哌替啶组)患者肌内注射25毫克哌替啶(=0.5毫升)。对照组则肌内注射0.5毫升0.9%生理盐水。15分钟后所有患者均接受脊髓麻醉。对针刺感觉丧失水平进行测量。持续监测环境温度和直肠温度,以评估手术期间体温变化对寒战的影响。由一位不知情的观察者仔细评估并记录寒战的程度和发生情况。两组之间在最大镇痛水平、环境温度和手术期间直肠温度变化方面无显著差异。生理盐水组有17例患者(56.7%)发生寒战,脊髓麻醉后发作时间为7.9±2.5分钟。哌替啶组仅3例患者(10%)发生寒战,脊髓麻醉后发作时间为54±29.5分钟。哌替啶组寒战发生率显著低于生理盐水组(p<0.005)。(摘要截短于250字)

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