Sutherland J, Seaton H, Lowry C
Department of Anaesthesia and Pain Management, Royal North Shore Hospital, St. Leonards Hospital, N.S.W., Australia.
Anaesth Intensive Care. 1991 May;19(2):228-32. doi: 10.1177/0310057X9101900214.
A prospective study of 94 patients undergoing elective lower segment caesarean section under epidural anaesthesia was performed in order to determine the incidence of shivering and the influence of epidural pethidine. Epidural anaesthesia was established with bupivacaine 0.5% with adrenaline, with or without additional lignocaine 2% with adrenaline, to total 20-25 ml. With the injection of epidural local anaesthesia an extra 5 ml of solution was administered into the epidural space--pethidine 25 mg preservative-free, in normal saline, or normal saline alone. Patient, administering anaesthetist and observer were blinded to the nature of the test substance. Shivering was assessed by an independent observer and subsequently rated by the patient. Other side-effects also recorded were nausea, vomiting, pruritus and drowsiness. The incidence of shivering was 36% in the control (saline) group and 11% in the pethidine group. The difference was highly significant (P less than 0.01). There was no significant difference in the incidence of maternal nausea, vomiting, drowsiness or pruritus, or neonatal Apgar scores. Cord blood samples were assayed for pethidine, revealing low or absent pethidine concentrations.
为了确定寒颤的发生率以及硬膜外哌替啶的影响，对94例在硬膜外麻醉下接受择期下段剖宫产的患者进行了一项前瞻性研究。使用含肾上腺素的0.5%布比卡因建立硬膜外麻醉，可加用或不加用含肾上腺素的2%利多卡因，总量为20 - 25毫升。在注射硬膜外局部麻醉药时，向硬膜外腔额外注入5毫升溶液——25毫克无防腐剂的哌替啶溶于生理盐水，或仅注入生理盐水。患者、麻醉实施者和观察者均对受试物质的性质不知情。寒颤由一名独立观察者评估，随后由患者进行评分。还记录了其他副作用，如恶心、呕吐、瘙痒和嗜睡。对照组（生理盐水）寒颤发生率为36%，哌替啶组为11%。差异具有高度显著性（P < 0.01）。产妇恶心、呕吐、嗜睡或瘙痒的发生率以及新生儿阿普加评分均无显著差异。对脐血样本进行哌替啶检测，结果显示哌替啶浓度较低或未检出。
