Mercadante S, De Michele P, Letterio G, Pignataro A, Sapio M, Villari P
Department of Anesthesia and Intensive Care, Buccheri La Ferla Fatebenefratelli Hospital, Palermo, Italy.
J Pain Symptom Manage. 1994 Jul;9(5):294-7. doi: 10.1016/0885-3924(94)90186-4.
In obstetric patients treated with epidural analgesia during labor and delivery, shivering is quite frequent due to stress, vasodilatation, infusion of fluids, low ambient temperature, and the direct effect of solution injected into the epidural space. Sixty obstetric patients who developed shivering after receiving epidural analgesia for delivery were randomly assigned to treatment with clonidine 0.150 mg i.v. (N = 20), meperidine 50 mg i.v. (N = 20), or saline solution (N = 20). Drug administration was double blind. The effect on shivering (graded as all or none), drowsiness, heart rate, and systolic arterial pressure was evaluated 5 min after the study drug was administered. Clonidine was as effective as meperidine in controlling shivering and caused a greater reduction in heart rate. Drowsiness occurred after clonidine as well as meperidine. Thus, clonidine proved to be effective in controlling shivering and adrenergic response after delivery using epidural analgesia and produced an acceptable level of drowsiness.
在分娩过程中接受硬膜外镇痛的产科患者中，由于应激、血管扩张、液体输注、环境温度低以及注入硬膜外腔的溶液的直接作用，寒战相当常见。60名在接受硬膜外分娩镇痛后出现寒战的产科患者被随机分为三组，分别静脉注射0.150毫克可乐定（N = 20）、50毫克哌替啶（N = 20）或生理盐水（N = 20）。给药采用双盲法。在给予研究药物5分钟后，评估对寒战（分为完全缓解或未缓解）、嗜睡、心率和收缩压的影响。可乐定在控制寒战方面与哌替啶同样有效，且能使心率有更大程度的降低。可乐定和哌替啶给药后均出现嗜睡。因此，事实证明可乐定在使用硬膜外镇痛分娩后控制寒战和肾上腺素能反应方面有效，并产生了可接受程度的嗜睡。
