Wrench I J, Singh P, Dennis A R, Mahajan R P, Crossley A W
University Department of Anaesthesia, Queen's Medical Centre, Nottingham, UK.
Anaesthesia. 1997 Jan;52(1):32-6. doi: 10.1111/j.1365-2044.1997.006-az006.x.
This study was designed to find the minimum effective doses of doxapram and pethidine to stop post-anaesthetic shivering. Two hundred and twenty healthy patients who shivered following routine surgery were allocated randomly to receive one of 10 doses of doxapram (0.18, 0.23, 0.29, 0.35, 0.41, 0.47, 0.7, 0.93, 1.17 and 1.4 mg.kg-1), one of five doses of pethidine (0.12, 0.18, 0.23, 0.29 and 0.35 mg.kg-1) or saline. Probit analysis demonstrated that the number of patients who stopped shivering with doxapram was independent of the amount of drug given in this dose range. The lowest dose of doxapram (0.18 mg.kg-1) was significantly more effective than placebo (p < 0.01). For pethidine there was a dose-dependent effect on shivering to a maximum of 95% of patients successfully treated with 0.35 mg.kg-1. We conclude that 0.35 mg.kg-1 of pethidine is the minimum dose required to treat post-anaesthetic shivering effectively. We also conclude that 0.18 mg.kg-1 of doxapram is as effective as 1.4 mg.kg-1 in the treatment of post-anaesthetic shivering. Further study is required to find the minimum effective dose of doxapram.
本研究旨在找出多沙普仑和哌替啶用于停止麻醉后寒战的最小有效剂量。220例常规手术后出现寒战的健康患者被随机分配，接受10种剂量多沙普仑（0.18、0.23、0.29、0.35、0.41、0.47、0.7、0.93、1.17和1.4mg·kg⁻¹）中的一种、5种剂量哌替啶（0.12、0.18、0.23、0.29和0.35mg·kg⁻¹）中的一种或生理盐水。概率分析表明，在此剂量范围内，使用多沙普仑停止寒战的患者数量与给药量无关。多沙普仑的最低剂量（0.18mg·kg⁻¹）比安慰剂显著更有效（p<0.01）。对于哌替啶，对寒战有剂量依赖性效应，最高可达95%的患者用0.35mg·kg⁻¹成功治疗。我们得出结论，0.35mg·kg⁻¹的哌替啶是有效治疗麻醉后寒战所需的最小剂量。我们还得出结论，0.18mg·kg⁻¹的多沙普仑在治疗麻醉后寒战方面与1.4mg·kg⁻¹一样有效。需要进一步研究以找出多沙普仑的最小有效剂量。
