右美托咪定预防老年患者全身麻醉后寒战的临床观察
Clinical research of different loading doses of dexmedetomidine for preventing elderly postoperative shivering
目的:探讨右美托咪定预防老年患者全身麻醉后寒战的最佳有效剂量。方法选择100例择期行开腹手术的老龄患者,采用随机数字表法分为四组:A组(0.9%氯化钠注射液组),B 组(右美托咪定0.25μg/kg),C组(右美托咪定0.5μg/kg),D组(右美托咪定0.75μg/kg)。观察各组患者术后寒战发生情况及围术期和术后不良反应。结果 C、D组寒战发生率为24%、20%,较A组的64%明显降低(χ2=5.333、6.876,均P<0.05),但C、D两组间差异无统计学意义(χ2=0.117,P>0.05)。各组肛温差异无统计学意义(F=1.271,P>0.05),拔管时间D组(24.4±2.8)min,较A组的(21.6±4.0)min明显延长(F=6.194,P<0.05)。结论给予0.5μg/kg、0.75μg/kg右美托咪定可有效预防老年患者全身麻醉后寒战的发生,但随着剂量增大,可产生拔管时间延长等不良影响,提示0.5μg/kg剂量最为合适。
更多Objective To investigate different dosage of dexmedetomidine for preventing elderly postanes-thetic shivering.Methods 100 ASAⅠ~Ⅱ elderly patients (60~80 ages)scheduled for laparotomy were enrolled in this study.According to a computer-generated list of random numbers,patients were randomly allocated to receive dexmedetomidine in the four groups:group A (0.9%normal saline),group B (dexmedetomidine 0.25μg/kg),group C (dexmedetomidine 0.5μg/kg),group D (dexmedetomidine 0.75μg/kg).The occurrence of postanesthetic shive-ring and adverse reactions in perioperative period and post operation were observed.Results The incidence rate shiv-ering were 24% and 20% in group C and D,which were significantly lower than 64% in group A (χ2 =5.333,6. 876,all P<0.05),but there was no difference between C and D groups(χ2 =0.117,P>0.05).Rectal temperature was no difference among four groups(F=1.271,P>0.05).Extubation time was shorter in group A(21.6 ±4.0)min than that in group D(24.4 ±2.8)min(F=6.194,P<0.05).Conclusion Our results suggest that dexmedetomi-dine 0.5 or 0.75 μg/kg can prevent shivering after general anesthesia effectively.But potential for delayed extubation time with dexmedetomidine was noted.The loading dose of 0.5 μg/kg dexmedetomidine is recommeded to prevent eld-erly shivering after general anesthesia.
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