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1、小劑量布托啡諾和氫化潑尼松治療老年骨科手術(shù)中寒戰(zhàn)的效果觀察小劑量布托啡諾和氫化潑尼松治療老年骨科手術(shù)中寒戰(zhàn)的效果觀察沈志恩(浙江省杭州市蕭山中醫(yī)院麻醉科,浙江杭州311200)摘要目的:評(píng)價(jià)小劑量布托啡諾和氫化潑尼松在治療老年骨科手術(shù)中寒戰(zhàn)的效果。方法選擇老年病人硬膜外麻醉下行股骨粗隆骨折內(nèi)固定、半髖置換術(shù)、全膝置換術(shù)發(fā)生寒戰(zhàn)的患者60例,ASAⅠ~Ⅱ級(jí),隨機(jī)分成小劑量布托啡諾+氫化潑尼松組A組和哌替啶組B組,每組30例。用藥后觀察患者寒戰(zhàn)改善情況,不良反應(yīng)及心電圖ECG,平均動(dòng)脈壓MAP,心率HR,動(dòng)脈血氧飽和度SpO2。結(jié)果兩組用藥后
2、治療寒戰(zhàn)有效率無(wú)差異性,B組惡心、嘔吐發(fā)生率較A組高,兩組間差異有統(tǒng)計(jì)學(xué)意義P0.05,B組用藥后HR呈一過(guò)性增快,與用藥前比較有統(tǒng)計(jì)學(xué)意義P0.05。結(jié)論小劑量布托啡諾和氫化潑尼松在治療硬膜外麻醉下老年骨科手術(shù)中寒戰(zhàn)療效優(yōu)于哌替啶,對(duì)老年循環(huán)干擾輕,不良反應(yīng)少。[關(guān)鍵詞】寒戰(zhàn);布托啡諾;氫化潑尼松;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中圖分類號(hào)R614文獻(xiàn)標(biāo)識(shí)碼A術(shù)中寒戰(zhàn)是指麻醉手術(shù)中患者圍手術(shù)期間出現(xiàn)不隨意的肌肉收縮,同時(shí)伴有外周血管收縮和中心體溫下降,主要發(fā)生在上肢、頸和頜
8、部肌群[1]。硬膜外麻醉的發(fā)生率大約為30%。老年骨科手術(shù)硬膜外麻醉后寒戰(zhàn)使機(jī)體氧耗量增大,嚴(yán)重者可致低氧血癥及酸中毒、心律失常,增加痛苦,對(duì)康復(fù)不利,故治療圍手術(shù)期間的寒戰(zhàn)十分必要。本研究評(píng)
