Yang C H, Yu C C, Seah Y S, Chan H C, Tan P P
Department of Anesthesiology, Chang Gung Memorial Hospital.
Ma Zui Xue Za Zhi. 1993 Jun;31(2):121-6.
The effects of intravenous clonidine, a central adrenergic alpha-2 agonist, on the incidence of shivering and hemodynamic changes after epidural anesthesia were assessed in patients undergoing extracorporeal shock wave lithotripsy (ESWL). Forty ASA class I or II patients were randomly assigned in a double-blind manner to one of two groups. Twenty patients received intravenous clonidine 150 micrograms/10 ml (clonidine group) and twenty patients received normal saline (control group) at 20 min before epidural administration of 1.5% lidocaine. Shivering was determined objectively by observing involuntary muscle activity. Arterial blood pressure, heart rate, respiratory rate and oxygen saturation were measured at 5-min intervals during the first 50 minutes following IV pretreatment. There was significant difference between clonidine and control groups in the incidence of shivering (5% vs. 55%, p = 0.002). Shivering began at an average of 16.8 +/- 9 min (range: 5-30 min) in control group and only one patient shivered at 18 min in clonidine group. The mean sensory level was T7 in both groups. There were no differences between the two groups in mean arterial pressure and respiratory rate, though there was a trend in reduction of MAP in clonidine group. Heart rate and oxygen saturation decreased slightly in clonidine group. The main adverse effect of clonidine pretreatment was drowsiness. In conclusion, intravenous clonidine 150 micrograms was effective in preventing shivering with minor hemodynamic changes in patients receiving epidural anesthesia.
在接受体外冲击波碎石术（ESWL）的患者中，评估了中枢肾上腺素能α2激动剂静脉注射可乐定对硬膜外麻醉后寒战发生率和血流动力学变化的影响。40例美国麻醉医师协会（ASA）I或II级患者以双盲方式随机分为两组。20例患者在硬膜外注射1.5%利多卡因前20分钟接受静脉注射可乐定150微克/10毫升（可乐定组），20例患者接受生理盐水（对照组）。通过观察不自主肌肉活动客观确定寒战情况。在静脉预处理后的前50分钟内，每隔5分钟测量动脉血压、心率、呼吸频率和血氧饱和度。可乐定组和对照组在寒战发生率上有显著差异（5%对55%，p = 0.002）。对照组寒战平均开始于16.8±9分钟（范围：5 - 30分钟），可乐定组仅1例患者在18分钟时出现寒战。两组的平均感觉平面均为T7。两组在平均动脉压和呼吸频率方面无差异，尽管可乐定组有平均动脉压降低的趋势。可乐定组的心率和血氧饱和度略有下降。可乐定预处理的主要不良反应是嗜睡。总之，静脉注射150微克可乐定可有效预防接受硬膜外麻醉患者的寒战，且血流动力学变化较小。
