Joris J, Banache M, Bonnet F, Sessler D I, Lamy M
Department of Anesthesiology, University Hospital of Liège, Belgium.
Anesthesiology. 1993 Sep;79(3):532-9. doi: 10.1097/00000542-199309000-00017.
Although meperidine is an effective treatment of postanesthetic shivering, its mechanism of action remains unknown. Investigation of other drugs might help clarify the mechanisms by which shivering can be controlled. Accordingly, we investigated the efficacy of clonidine, an alpha 2-adrenergic agonist, and ketanserin, a 5-hydroxytryptamine antagonist, in treating postanesthetic shivering.
First, 54 patients shivering after general anesthesia were allocated randomly to receive an intravenous bolus of saline, 150 micrograms clonidine, or 10 mg ketanserin. A second study explored the dose-dependence of clonidine. Forty shivering patients were given saline or clonidine, 37.5, 75, or 150 micrograms.
The duration of shivering was significantly shorter in those given clonidine (2.1 +/- 0.9 min) than in the other two groups and shorter in the ketanserin group (4.3 +/- 0.9 min) than in the saline group (12.0 +/- 1.6 min). Clonidine and ketanserin significantly decreased systolic arterial blood pressure when compared to saline. Core rewarming was significantly slower in the clonidine group. In the second study, 37.5 micrograms clonidine was no more effective than saline. Two minutes after treatment, 150 micrograms obliterated shivering in all patients. Five minutes after treatment, all patients given 75 micrograms had stopped shivering. Systolic arterial pressure and heart rate decreased significantly in patients given 75 and 150 micrograms clonidine.
Clonidine (150 micrograms) and ketanserin (10 mg) both are effective treatment for postanesthetic shivering. The effect of clonidine on shivering is dose-dependent: whereas 37.5 micrograms had no effect, 75 micrograms clonidine stopped shivering within 5 min.
尽管哌替啶是治疗麻醉后寒战的有效药物，但其作用机制仍不清楚。研究其他药物可能有助于阐明控制寒战的机制。因此，我们研究了α2肾上腺素能激动剂可乐定和5-羟色胺拮抗剂酮色林治疗麻醉后寒战的疗效。
首先，将54例全身麻醉后发生寒战的患者随机分为三组，分别静脉推注生理盐水、150微克可乐定或10毫克酮色林。第二项研究探讨了可乐定的剂量依赖性。40例寒战患者给予生理盐水或37.5、75或150微克可乐定。
给予可乐定的患者寒战持续时间（2.1±0.9分钟）明显短于其他两组，酮色林组（4.3±0.9分钟）短于生理盐水组（12.0±1.6分钟）。与生理盐水相比，可乐定和酮色林显著降低收缩动脉血压。可乐定组的核心复温明显较慢。在第二项研究中，37.5微克可乐定的效果并不比生理盐水好。治疗两分钟后，150微克可乐定使所有患者的寒战消失。治疗五分钟后，所有给予75微克可乐定的患者均停止寒战。给予75和150微克可乐定的患者收缩动脉压和心率显著下降。
可乐定（150微克）和酮色林（10毫克）均是治疗麻醉后寒战的有效药物。可乐定对寒战的作用具有剂量依赖性：37.5微克无效，而75微克可乐定在5分钟内可停止寒战。
