Casey W F, Smith C E, Katz J M, O'Loughlin K, Weeks S K
Department of Anaesthesia, Royal Victoria Hospital, Montreal, Quebec.
Can J Anaesth. 1988 Mar;35(2):128-33. doi: 10.1007/BF03010651.
To determine the efficacy of meperidine in controlling shivering during epidural anaesthesia for Caesarean section, forty-six parturients were studied. After delivery of the infant, shivering patients received either a single dose of intravenous meperidine 50 mg, or saline in a randomized double-blind fashion. Shivering was classified on a scale of 0 to 3 (grade 0 = none, grade 3 = severe shivering that was distressing to the patient and interfered with monitoring). Shivering and other variables were recorded at epidural placement, skin incision, delivery, and 2, 5, 15, 30 and 60 minutes following injection. Administration of meperidine resulted in a significant decrease in both the overall incidence of shivering (87 to 35 per cent, p less than 0.01) and severity of shivering (grade 3:57 to 0 per cent, p less than 0.01), compared with saline (incidence: 87 to 83 per cent, grade 3:57 per cent, no change). This effect was apparent within two minutes of drug injection and persisted throughout the study period. There were no differences in vital signs, oxygen saturation or temperature between groups. The incidence of nausea was similar, although patients receiving meperidine were more drowsy at two and five minutes following injection (p less than 0.01) compared with patients in the saline group. There were no differences in level of consciousness at the later intervals. The mechanism of action of meperidine on shivering remains to be elucidated.
为确定哌替啶在剖宫产硬膜外麻醉期间控制寒战的疗效，对46名产妇进行了研究。婴儿娩出后，寒战患者以随机双盲方式接受单次静脉注射50mg哌替啶或生理盐水。寒战程度按0至3级分类（0级 = 无寒战，3级 = 严重寒战，使患者痛苦并干扰监测）。在硬膜外穿刺时、皮肤切开时、分娩时以及注射后2、5、15、30和60分钟记录寒战及其他变量。与生理盐水组（发生率：87%至83%，3级：57%，无变化）相比，哌替啶给药使寒战的总体发生率（87%降至35%，p<0.01）和寒战严重程度（3级：57%降至0%，p<0.01）均显著降低。这种效果在药物注射后两分钟内即明显出现，并在整个研究期间持续存在。两组之间的生命体征、血氧饱和度或体温无差异。恶心发生率相似，尽管与生理盐水组患者相比，接受哌替啶的患者在注射后2分钟和5分钟时更嗜睡（p<0.01）。在后续时间段意识水平无差异。哌替啶对寒战的作用机制尚待阐明。
