Bozgeyik Semsettin, Mizrak Ayse, Kılıç Ertuğrul, Yendi Fatih, Ugur Berna Kaya
Anesthesiology and Reanimation, Gaziantep University School of Medicine, Gaziantep/Turkey.
Saudi J Anaesth. 2014 Apr;8(2):238-43. doi: 10.4103/1658-354X.130729.
Shivering, the rate of which in regional anesthesia is 39% is an undesired complication seen postoperatively.
This study aims to compare the ability of preventing the shivering of preemptive tramadol and dexmedetomidine during the spinal anesthesia (SA).
A total of 90 patients with American Society of Anesthesiologists physical status I-II, aged 18-60 years and undergoing elective arthroscopic surgery with SA were divided into three groups randomly. After spinal block, 100 mg tramadol in 100 ml saline was applied in group T- (n = 30) and 0.5 μg/kg dexmedetomidine in 100 ml saline was applied in group D- (n = 30) and 100 ml saline was administered in group P- (n = 30) in 10 min. The hemodynamics, oxygen saturation, tympanic temperature, shivering and sedation scores were evaluated and recorded intraoperatively and 45 min after a postoperative period.
In group T and D, shivering scores were significantly lower when compared with group P in the intraoperative 20(th) min (P = 0.01). Sedation scores in group D were significantly higher than the baseline values (P = 0.03) and values in group T and P (P = 0.04).
Preemptive tramadol and dexmedetomidine are effective in preventing the shivering under SA. In addition, dexmedetomidine was superior in increasing the level of sedation which is sufficient to prevent the anxiety without any adverse effects.
寒战是术后出现的一种不良并发症，在区域麻醉中其发生率为39%。
本研究旨在比较在脊髓麻醉（SA）期间，超前给予曲马多和右美托咪定预防寒战的能力。
将90例美国麻醉医师协会身体状况分级为I-II级、年龄在18至60岁之间且接受SA下择期关节镜手术的患者随机分为三组。脊髓阻滞完成后，在10分钟内，T组（n = 30）给予100mg曲马多溶于100ml生理盐水中，D组（n = 30）给予0.5μg/kg右美托咪定溶于100ml生理盐水中，P组（n = 30）给予100ml生理盐水。术中及术后45分钟评估并记录血流动力学、血氧饱和度、鼓膜温度、寒战及镇静评分。
在术中第20分钟时，T组和D组的寒战评分与P组相比显著更低（P = 0.01）。D组的镇静评分显著高于基线值（P = 0.03）以及T组和P组的值（P = 0.04）。
超前给予曲马多和右美托咪定在SA下预防寒战有效。此外，右美托咪定在提高镇静水平方面更具优势，足以预防焦虑且无任何不良反应。
