He Liang, Xu Jun-Mei, Liu Su-Mei, Chen Zhi-Jun, Li Xin, Zhu Rong
Department of Anesthesiology, The Affiliated Hospital of Guilin Medical University.
Biol Pharm Bull. 2017;40(2):169-173. doi: 10.1248/bpb.b16-00651.
Shivering associated with spinal anesthesia during Cesarean delivery is an uncomfortable experience for the parturient, which may also cause adverse effects. In this prospective, randomized, double-blind, placebo-controlled study, we sought to evaluate the effect of intrathecal dexmedetomidine, administered as an adjunct to hyperbaric bupivacaine for Cesarean delivery, on the incidence and severity of shivering associated with spinal anesthesia. Patients undergoing Cesarean delivery were randomly allocated to three groups of 30 patients each. Experimental treatments were added to hyperbaric bupivacaine as follows: Patients in group I (control) were administered isotonic saline. Patients in groups II and III received dexmedetomidine (2.5, 5 µg, respectively), mixed with isotonic saline. Shivering was observed in 11, 10 and 2 patients in groups I, II and III, respectively. The incidence of shivering in group III was significantly lower than that in groups I (p=0.005) and II (p=0.01). The severity of shivering was significantly different between the three groups (p=0.01). There were no significant inter-group differences with respect to mean arterial pressure and heart rate at any time point after administration of intrathecal local anesthesia (p>0.05). Intrathecal dexmedetomidine (5 µg) administered as an adjunct to hyperbaric bupivacaine during Cesarean delivery significantly reduced the incidence and intensity of shivering associated with spinal anesthesia.
剖宫产术中脊髓麻醉相关的寒战对产妇来说是一种不适的体验，还可能会产生不良影响。在这项前瞻性、随机、双盲、安慰剂对照研究中，我们试图评估鞘内注射右美托咪定作为剖宫产高压布比卡因辅助用药，对脊髓麻醉相关寒战的发生率和严重程度的影响。接受剖宫产的患者被随机分为三组，每组30例。实验性治疗药物加入高压布比卡因中，具体如下：第一组（对照组）患者给予等渗盐水。第二组和第三组患者分别接受2.5μg、5μg右美托咪定与等渗盐水混合液。第一组、第二组和第三组分别有11例、10例和2例出现寒战。第三组寒战发生率显著低于第一组（p = 0.005）和第二组（p = 0.01）。三组之间寒战严重程度有显著差异（p = 0.01）。鞘内注射局部麻醉药后任何时间点，平均动脉压和心率在组间均无显著差异（p>0.05）。剖宫产术中鞘内注射右美托咪定（5μg）作为高压布比卡因的辅助用药，可显著降低脊髓麻醉相关寒战的发生率和强度。
