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1、小剂量布托啡诺和氢化泼尼松治疗老年骨科手术中寒战的效果观察小剂量布托啡诺和氢化泼尼松治疗老年骨科手术中寒战的效果观察沈志恩(浙江省杭州市萧山中医院麻醉科,浙江杭州311200)摘要目的:评价小剂量布托啡诺和氢化泼尼松在治疗老年骨科手术中寒战的效果。方法选择老年病人硬膜外麻醉下行股骨粗隆骨折内固定、半髋置换术、全膝置换术发生寒战的患者60例,ASAⅠ~Ⅱ级,随机分成小剂量布托啡诺+氢化泼尼松组A组和哌替啶组B组,每组30例。用药后观察患者寒战改善情况,不良反应及心电图ECG,平均动脉压MAP,心率HR,动脉血氧饱和度SpO2。结果两组用药后
2、治疗寒战有效率无差异性,B组恶心、呕吐发生率较A组高,两组间差异有统计学意义P0.05,B组用药后HR呈一过性增快,与用药前比较有统计学意义P0.05。结论小剂量布托啡诺和氢化泼尼松在治疗硬膜外麻醉下老年骨科手术中寒战疗效优于哌替啶,对老年循环干扰轻,不良反应少。[关键词】寒战;布托啡诺;氢化泼尼松;哌替啶BhuttobrownandsmalldoseofprednisoloneintreatmentofelderlyDepartmentoforthopedicsoperationofshiveringintheeffectobserva
3、tionShenZhienZhejiangprovinceHangzhoucityXiaoshanHospitaloftraditionalChineseMedicineDepartmentofAnesthesiology,ZhejiangHangzhou311200AbstractObjective:toevaluationofsmalldoseofBhuttobrownandprednisoloneinthetreatmentofelderlyDepartmentoforthopedicsoperationchilleffect.Me
4、thodfortheselectionofelderlypatientsunderEpiduralAnesthesiafemoralintertrochantericfracturefixation,hipreplacement,totalkneereplacementin60patientswithshiver,ASAⅠandⅡ,wererandomlydividedintosmalldoseofBhuttobutorphanol+prednisolonegroupgroupAandpethidinegroupBgroup,eachgr
5、oupof30cases.Aftertheimprovementobservedinpatientswithshiver,adversereactionsandtheelectrocardiogramECG,meanarterialpressureMAP,heartrateHR,arterialoxygensaturationSpO2.Resultsofthetwogroupsaftertreatmentofshiveringeffectivelynodifference,nausea,andvomitingingroupBinciden
6、cehigherthanthoseintheAgroup,thedifferencebetweenthetwogroupswasstatisticallysignificantP0.05,BgroupHRshowedtransientincreasesquickly,beforeandaftertreatmentcomparedwithstatisticalsignificanceP0.05.ConclusionthesmalldoseofBhuttobrownandprednisoloneinthetreatmentofelderlyD
7、epartmentoforthopedicsoperationunderepiduralanesthesiashiveringinsuperiorefficacyofpethidine,onoldloopinterferenceoflight,lessadversereaction.[Keywords]chills;Bhuttobutorphanol;prednisolone;pethidine中图分类号R614文献标识码A术中寒战是指麻醉手术中患者围手术期间出现不随意的肌肉收缩,同时伴有外周血管收缩和中心体温下降,主要发生在上肢、颈和颌
8、部肌群[1]。硬膜外麻醉的发生率大约为30%。老年骨科手术硬膜外麻醉后寒战使机体氧耗量增大,严重者可致低氧血症及酸中毒、心律失常,增加痛苦,对康复不利,故治疗围手术期间的寒战十分必要。本研究评
