Shukla Usha, Malhotra Kiran, Prabhakar T
Department of Anaesthesiology and Critical Care, UP Rural Institute of Medical Sciences & Research, Saifai, Etawah, Uttar Pradesh, India.
Indian J Anaesth. 2011 May;55(3):242-6. doi: 10.4103/0019-5049.82666.
The aim of this study was to evaluate the efficacy, potency and side effects of clonidine as compared to tramadol in post-spinal anaesthesia shivering. In this prospective double-blind randomized controlled clinical trial, 80 American Society of Anaesthesiologists grade-l (ASAI) patients aged between 18 and 45 years scheduled for various surgical procedures under spinal anaesthesia, who developed shivering were selected.The patients were divided into two groups: Group C (n=40) comprised of patients who received clonidine 0.5mg/kg intravenously (IV) and group patients who received tramadol 0.5 mg/kg IV. Grade of shivering, disappearance of shivering, haemodynamics and side effects were observed at scheduled intervals. Disappearance of shivering was significantly earlier in group C (2.54±0.76) than in group T (5.01±1.02) (P=.0000001). Response rate to treatment in group C was higher (97.5%) than in group T (92.5%), but the difference was not significant. Nausea, vomiting and dizziness were found to be higher in group T (P=0.001, 0.005, 0.001, respectively), while the patients in group C were comparatively more sedated (sedation level, 2; group C, 25%). We conclude that clonidine gives better thermodynamics than tramadol, with fewer side effects.
本研究旨在评估可乐定与曲马多相比,在脊麻后寒战中的疗效、效能及副作用。在这项前瞻性双盲随机对照临床试验中,选取了80例年龄在18至45岁之间、拟行脊麻下各种外科手术且发生寒战的美国麻醉医师协会1级(ASA I)患者。患者被分为两组:C组(n = 40)由静脉注射0.5mg/kg可乐定的患者组成,T组由静脉注射0.5mg/kg曲马多的患者组成。在预定时间间隔观察寒战程度、寒战消失情况、血流动力学及副作用。C组寒战消失时间(2.54±0.76)明显早于T组(5.01±1.02)(P = 0.0000001)。C组治疗有效率(97.5%)高于T组(92.5%),但差异无统计学意义。T组恶心、呕吐及头晕发生率更高(分别为P = 0.001、0.005、0.001),而C组患者镇静程度相对较高(镇静水平2级;C组为25%)。我们得出结论,可乐定在控制寒战方面比曲马多效果更好,且副作用更少。