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1、曲马多预防全麻腹腔镜胆囊切除患者术后寒战的临床观察作者:李霞单位:新疆医科大学第五附属医院麻醉科,新疆乌鲁木齐【摘要】目的:探讨曲马多対全麻腹腔镜胆囊切除患者术后寒战的影响。方法:择期行腹腔镜胆囊切除患者60例,ASAI〜I[级,随机分为2组,即曲马多组和生理盐水组,每组30例。常规全麻诱导及维持,术毕麻醉苏醒前,曲马多组给予曲马多1mg/kg静注,生理盐水组给予生理盐水0.05ml/kg静注。观察患者术中、术后的临床资料、术后寒战发生率及寒战程度Wrench分级。结果:2组病人拔出气管导管后的平均动脉
2、压(MAP)和尤率(HR)、术中补液量、麻醉时间、手术时间、苏醒时间差异均无统计学意义(P<0.05)o曲马多组术后寒战发牛率为6.6%,明显低于生理盐水组寒战发生率(20.0%)(P<0.0l)o结论:曲马多可用于腹腔镜胆囊切除术后寒战的预防。【关键词】曲马多胆囊切除全麻寒战Clinicalobservationoftramadolpreventofshiveringofthepatientsafterlaparoscopiccholecystectomywithgeneralanesth
3、esiaLIXia,ZHANGJing,ZHANGXi,etalDepartmentofAnesthsia,FifthAffiliatedHospital,XinjiangMedicalUniversity,Urumqi830011,China)Abstract:Objective:Toinvestigatetheinfluenceoftramadoltopreventshiveringafterlaparoscopiccholecystectomywithgeneralanesthesia・Metho
4、ds:SixtypatientsunderlaparoscopiccholecystectomywithASAI~IIclasswererandomlydividedtwogroups:thetroupoftramadolandtheotherofsaline30caseseach・Conventionalinductionandmaintenanceofgeneralanesthesia,afteroperationandbeforewake,tramadolwasintravenouswith1mg
5、/kgintramadoltroupandsalinewith0.05ml/kginsalinegroup.Shiveringanditsdegreeofpostoperationwereobserved.Results:Themeanarterialpressure(MAP)andheartrate(HR)werenotstatisticallysignificantintwogroups;Thetimeofanesthsia,operationandawakewerenotstatistically
6、significant;Therateofshiveringoccurredintramadolgroupwas6.6%andtheother20.0%,therewasstatisticallysignificance(P<0.01).Conclusion:Tramadolcouldpreventtheshiveringofthepatientsafterlaparoscopiccholecystectomy.Keywords:tramadol;cholecystectomy;shivering
7、aftergeneralanesthesia术后寒战是有节律的肌肉运动,主要发生在上肢、颈和颌部肌群[1]。全麻病人恢复期寒战发生率为5%〜70%,寒战会增加代谢率达400%[2],易产生乳酸中毒、动脉低氧血症、眼内压增高,引起患者烦躁。在控制寒战的药物中,一些药不良反应较多,曲马多是一•种非阿片类中枢镇痛药,近來开始应用于拈抗患者术毕寒战反应。木研究评价曲马多对全麻后患者寒战的影响,为临床应用提供参考。1资料与方法1」临床资料60例择期全麻腹腔镜胆囊切除术的病人,男性38例,女性22例,年龄17〜73
8、岁,体亜45〜67kg,ASAI〜II级。随机分为2组,曲马多组30例,男性18例,女性12例,年龄平均(47.0±l&7)岁,体重平均(53.0±19.7)kgo生理盐水组30例男性20例,缁10例,年龄平均(44.0±20.3)岁,体重平均(56.0±20.1)kg,2组一般资料经检验差异无统计学意义(P<().()5),具有可比性。2组均无发热、甲状腺疾病、代谢方而疾病及人