盐酸右美托咪定对预防剖宫产患者椎管内麻醉期间寒战反应的效果分析

目的：通过观察盐酸右美托咪定在预防剖宫产患者椎管内麻醉期间寒战反应的临床效果，评价其疗效，探讨其临床适用性。方法：选择2012年9月至2013年3月在我院接受椎管内麻醉行剖宫产的患者120例，随机分为观察组和对照组，每组60例。观察组患者在胎儿剖出后采取静脉注射盐酸右美托咪定，对照组患者则采取静脉注射生理盐水。分别观察并比较两组患者麻醉前、腰麻后5min、胎儿剖出时、盐酸右美托咪定静脉注射后10min、手术结束时的心血管循环系统变化情况，Ramsay镇静评分情况，寒战等不良反应的发生情况。结果：两组产妇的血压在腰麻后5min较麻醉前降低，在胎儿剖出后开始逐渐回升，手术结束时均恢复基础水平，但组间比较差异无统计学意义（P〉0．05）。观察组产妇心率在注射盐酸右美托咪定后较麻醉前明显降低（P〈0．05），较对照组也明显减慢（P〈O．05）；观察组产妇Ramsay镇静评分在注射盐酸右美托咪定后较麻醉前明显升高，较对照组也明显升高（P〈0．05），但均未发生镇静过度；观察组寒战的发生率为8．33％，明显低于对照组的发生率，差异有统计学意义（X^2=4．18，P〈0．05）；观察组用药后不良反应发生率为15．00％，与对照组的发生率相当，差异无统计学意义（X^2=0．24，P〉0．05）。结论：盐酸右美托咪定对于预防剖宫产患者椎管内麻醉期间寒战反应有一定的临床效果，适合临床长期推广应用。

Clinical Analysis of Dexmedetomidine on Post-epidural Anesthesia Shivering in Cesarean Women

Objective： To observe the clinical efficacy of dexmedetomidine on post-epidural anesthesia shivering in cesarean women. Methods： 120 cases who were treated with dexmedetomidine after the cesarean section in our hospital fi＇om September 2012 to March 2013 were randomly divided into the observation group and the control group, 60 patients in each group. Patients in the observa- tion group were given dexmedetomidine, while patients in the control group were given saline. Then we observed and compared the cir- culatory system changes, Ramsay score, shivering and other adverse reactions before anesthesia, after spinal anesthesia for 5 min, fetus dissected out, after giving the hydrochloric dexmedetomidine for 10 min and after the end of surgery respectively. Results： After thespinal anesthesia for 5 min, the sets of maternal blood pressure of patients in two groups were lower than before, but there was no statistically significant difference between two groups（P〉0.05）. The heart rate of the observation group was significantly lower than before, and com- pared with the control group were slower （P 〈0.05）;the maternal Ramsay score of the observation group was significantly higher than be- fore and the control group without excessive sedation （P 〈0.05）; the shivering rare of the observation group was 8.33% which was lower than that of the control group, and there was statistically significant difference between two groups （X^2 = 4.18, P 〈0.05）; the rate of ad- verse reaction in the observation group was 15.00%, and there was no statistically significant difference between two groups （X^2 = 0.24, P〉 0.05）. Conclusions： Dexmedetomidine can reduce the shivering on post-epidural anesthesia in cesarean women.