Guha Banerjee Sarmila, Nath Pallab Kumar, Halder Rita, Bandyopadhyay Ujjwal
Department of Anaesthesiology, Medical College, Kolkata, West Bengal, India.
Department of Pathology, Calcutta National Medical College, Kolkata, West Bengal, India.
Anesth Essays Res. 2017 Apr-Jun;11(2):477-482. doi: 10.4103/aer.AER_6_17.
This study aimed to evaluate the relative efficacy of prophylactic intravenous (IV) clonidine and tramadol for control of intraoperative shivering following spinal anesthesia.
After institutional ethical clearance, 142 patients were chosen from either gender, aged 20-60 years, physical status American Society of Anesthesiology Class I and II scheduled for elective infraumbilical surgery under spinal anesthesia. Patients were randomized into two groups: Group C ( = 71) received injection clonidine 50 μg) IV in 100 ml normal saline (NS) over 10 min and Group T ( = 71) received injection tramadol 50 mg IV. In 100 ml NS over 10 min after spinal anesthesia.
Incidence of shivering was not significant when compared between the two groups ( > 0.05). The axillary temperatures fell significantly in Group C from the baseline and remained at a significantly lower level up to 60 min after rescue drug was administered in patients who shivered. There was a similar fall in axillary temperature in Group T in patients having shivering, but the difference was not significant. When compared between the two groups among patients who shivered, the difference in fall of temperature was not significant. Side effects such as hypotension, bradycardia, and sedation were significantly more common in clonidine group, whereas nausea was significantly more common patients of tramadol group.
Prophylactic administration of both tramadol and clonidine is effective for controlling shivering under spinal anesthesia. However, tramadol is better because of higher response rate, less sedation, and lesser hemodynamic alterations.
本研究旨在评估预防性静脉注射可乐定和曲马多对脊髓麻醉后术中寒战的控制效果。
经机构伦理审查批准后，选取142例年龄在20 - 60岁、美国麻醉医师协会身体状况分级为I级和II级、计划在脊髓麻醉下进行择期脐下手术的患者，男女不限。患者被随机分为两组：C组（n = 71）在10分钟内静脉注射100 ml生理盐水中含50 μg可乐定注射液，T组（n = 71）在脊髓麻醉后10分钟内静脉注射100 ml生理盐水中含50 mg曲马多注射液。
两组之间寒战发生率比较无显著差异（P > 0.05）。C组患者的腋窝温度较基线显著下降，在寒战患者给予抢救药物后直至60分钟仍显著低于基线水平。T组寒战患者的腋窝温度也有类似下降，但差异不显著。在寒战患者中比较两组，体温下降差异不显著。可乐定组低血压、心动过缓和镇静等副作用明显更常见，而曲马多组恶心明显更常见。
预防性给予曲马多和可乐定对脊髓麻醉下控制寒战均有效。然而，曲马多效果更好，因为其反应率更高、镇静作用更小且血流动力学改变更小。
