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纳布啡与右美托咪定治疗剖宫产孕妇腰麻-硬膜外联合麻醉后寒战的比较

Nalbuphine versus dexmedetomidine for treatment of combined spinal-epidural post-anesthetic shivering in pregnant women undergoing cesarean section.

作者信息

Sun Jing, Zheng Zhao, Li Yi-Lu, Zou Li-Wei, Li Ge-Hui, Wang Xiao-Guang, She Bao-Zuan, Huang Xiao-Lei, Li Yuan-Tao

机构信息

Department of Anesthesiology, Affiliated Shenzhen Maternity and Child Healthcare Hospital, Southern Medical University, Shenzhen, Guangdong, China.

出版信息

J Int Med Res. 2019 Sep;47(9):4442-4453. doi: 10.1177/0300060519865063. Epub 2019 Jul 29.

Abstract

OBJECTIVE

This study aimed to compare the clinical efficacy and side effects of nalbuphine and dexmedetomidine for treatment of combined spinal-epidural anesthetic shivering in women after cesarean section.

METHODS

A total of 120 pregnant women, who underwent elective cesarean section under combined spinal-epidural anesthesia, were enrolled in a double-blind, randomized study. These women were randomized into three groups of 40 pregnant women each to receive either saline (group C), nalbuphine 0.07 mg/kg (group N), or dexmedetomidine 0.5 µg/kg (group D) for treatment of shivering after anesthesia. The main outcome measure was a significant reduction in the time required for shivering after intervention.

RESULTS

The mean time to cessation of shivering in groups N and D was significantly shorter than that in group C (3.5±2.7 and 4.2±3.7 versus 14.5±1.4 minutes). The success rate of shivering treatment and Observer’s Assessment of Alertness/Sedation scores in groups N and D were significantly higher than those in group C, while the recurrence rate was lower than that in group C.

CONCLUSION

Nalbuphine 0.07 mg/kg can be used safely and effectively for shivering in pregnant women under combined spinal-epidural anesthesia.

摘要

目的

本研究旨在比较纳布啡和右美托咪定治疗剖宫产术后妇女腰硬联合麻醉后寒战的临床疗效和副作用。

方法

共有120例行择期剖宫产腰硬联合麻醉的孕妇纳入一项双盲随机研究。这些孕妇被随机分为三组,每组40名,分别接受生理盐水(C组)、0.07mg/kg纳布啡(N组)或0.5μg/kg右美托咪定(D组)治疗麻醉后寒战。主要观察指标是干预后寒战停止所需时间显著缩短。

结果

N组和D组寒战停止的平均时间显著短于C组(分别为3.5±2.7分钟和4.2±3.7分钟,而C组为14.5±1.4分钟)。N组和D组寒战治疗成功率及观察者警觉/镇静评分显著高于C组,而复发率低于C组。

结论

0.07mg/kg纳布啡可安全有效地用于腰硬联合麻醉下孕妇的寒战治疗。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f854/6753531/1ca59b0a61a5/10.1177_0300060519865063-fig1.jpg

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