使用口服曲马多预防脊柱麻醉手术患者麻醉后寒战

S. Acharya, Sanam Dangol
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摘要

颤抖是脊椎麻醉后常见且令人痛苦的问题,其发生是由于热量损失和身体热量从核心到外围的重新分布,导致核心体温降低。麻醉后颤抖具有有害的代谢和心血管影响,理想情况下应通过与许多物理方法相比在所有情况下经济可行的药理学方法来预防。因此,本研究使用中枢镇痛药,口服盐酸曲马多预防脊髓麻醉后的肛周颤抖。这项前瞻性观察性研究对106名年龄在15至70岁之间的ASA I或II患者进行了研究,这些患者在脊柱麻醉下接受下肢或下腹手术。术中评估了麻醉后的颤抖。在11名(10.4%)患者中观察到颤抖,其中2名(1.9%)患者为1级,6名(5.7%)患者为2级,2名(19%)患者为3级,1名(0.9%)患者为4级。19例(17.9%)患者出现镇静。这项研究的结果表明,口服曲马多是非常安全的,优于迄今为止研究的各种药物,可以作为预防性用药的一部分,用于预防在脊柱麻醉下接受手术的患者麻醉后颤抖。
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Use of Oral Tramadol to Prevent Post-anaesthetic Shivering in Patients Undergoing Surgery under Spinal Anaesthesia
Shivering is a common and distressing problem after spinal anaesthesia which occurs due to heat loss and core to peripheral redistribution of body heat, resulting in reduction of core body temperature. Post anaesthetic shivering has deleterious metabolic and cardiovascular effect which should ideally be prevented by pharmacological methods that are economically and practically feasible in all settings compared to many physical methods. Therefore, this study was conducted using a centrally acting analgesic, oral Tramadol hydrochloride prophylactically for the prevention of perianaesthetic shivering after spinal anaesthesia. This prospective observational study was carried out in 106 patients of ASA I or II, aged 15 to 70 yrs of age undergoing lower limb or lower abdominal surgery under spinal anaesthesia. Postanaesthetic shivering was evaluated during the surgery. Shivering was observed in 11 (10.4%) patients and among them 2 (1.9%) patients had grade 1, 6 (5.7%) patients had grade 2, 2 (1.9%) patients had grade 3 and 1 (0.9%) patients had grade 4 type of shivering. Sedation was observed in 19 (17.9%) patients. The result of this study concluded that oral tramadol is very safe and superior to various drugs studied till date and can be used prophylactically as a part of premedication for the prevention of postanaesthetic shivering in patients undergoing surgery under spinal anaesthesia.
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