Samimi Sadeh Saghar, Hashemi Elham, Aminnejad Reza, Bastanhagh Ehsan
Department of Anesthesiology and Critical Care, Tehran University of Medical Sciences, Tehran, Iran.
School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
Anesth Pain Med. 2020 Oct 20;10(5):e106220. doi: 10.5812/aapm.106220. eCollection 2020 Oct.
Following surgery, patients frequently suffer from shivering, and this can lead to postoperative complications and discomfort.
This study aimed to compare the effect of ketamine on patients' shivering following an elective abdominal hysterectomy. Patients were given either Ketamine (0.25 mg or 0.5 mg/kg) or a placebo. The study and surgery took place in a subspecialty University Hospital for Gynecology and Obstetrics.
This study was an interventional, randomized, controlled clinical trial. Ninety-six women who underwent elective abdominal hysterectomy were randomly assigned to three groups. Ketamine was administered to all participants 20 min prior to the end of surgery. The first group received 0.25 mg/kg of intravenous ketamine. The second group received 0.5 mg/kg intravenous ketamine. The third group received a placebo of intravenous saline. Postoperative shivering, sedation grade, hallucination, nausea, vomiting, and nystagmus were measured for each patient up to 30 minutes.
The study showed that patients suffered from less shivering in the two groups that received ketamine. The reduced shivering was seen 5, 10, and 20 min following surgery in the two groups that were given two doses of 0.25 and 0.5 mg/kg ketamine compared to the control group (P value < 0.05). There was a significant difference between patients receiving normal saline and those having 0.25 and 0.5 mg/kg of ketamine in the rate of sedation grade, nausea, vomiting, and nystagmus (P value < 0.05). The main differences in patients receiving ketamine were the sedation grade at zero time and postoperative hallucination experienced by those patients who received 0.5 mg/kg of ketamine.
Ketamine reduced shivering in all patients following elective abdominal hysterectomy. This was regardless of dose. Patients were less likely to suffer from hallucinations and sedation grade with a lower dose of ketamine (0.25 mg/kg compared to 0.50 mg/kg).
手术后，患者经常会出现寒战，这可能导致术后并发症和不适。
本研究旨在比较氯胺酮对择期腹部子宫切除术后患者寒战的影响。患者分别接受氯胺酮（0.25毫克或0.5毫克/千克）或安慰剂。该研究及手术在一家大学妇产科专科医院进行。
本研究为一项干预性、随机、对照临床试验。96例行择期腹部子宫切除术的女性被随机分为三组。所有参与者在手术结束前20分钟给予氯胺酮。第一组接受0.25毫克/千克静脉注射氯胺酮。第二组接受0.5毫克/千克静脉注射氯胺酮。第三组接受静脉注射生理盐水安慰剂。对每位患者术后30分钟内的寒战、镇静分级、幻觉、恶心、呕吐和眼球震颤进行测量。
研究表明，接受氯胺酮的两组患者寒战较少。与对照组相比，给予两剂0.25毫克/千克和0.5毫克/千克氯胺酮的两组患者在术后5分钟、10分钟和20分钟时寒战减少（P值<0.05）。接受生理盐水和接受0.25毫克/千克及0.5毫克/千克氯胺酮的患者在镇静分级、恶心、呕吐和眼球震颤发生率方面存在显著差异（P值<0.05）。接受氯胺酮患者的主要差异在于零时的镇静分级以及接受0.5毫克/千克氯胺酮患者术后出现的幻觉。
氯胺酮可减少择期腹部子宫切除术后所有患者的寒战。这与剂量无关。较低剂量的氯胺酮（0.25毫克/千克与0.50毫克/千克相比）使患者出现幻觉和镇静分级的可能性较小。
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