Abstract: 【Abstract】〓Objective〓To investigate the effect of dexmedetomidine and tramadol on preventing shivering in patients during spinal and epidural anesthesia. Methods〓Sixty ASA Ⅰ-Ⅱpatients undergoing selective lower extremity operation under spinal and epidural anesthesia were randomized into three groups..Twenty patients were randomized group D:..intravenous injection of dexmedetomidine 0.5 μg/kg preoperatively,.group T:.intravenous injection of Tramadol 2 mg/kg preoperatively,.and group C:.intravenous saline 0.9% injection of the same dose..The changes of vital signs after injection were recorded..The occurrence of shivering and Ramsay sedation score.(RSS) were observed. Results〓Group D and Group T had a lower shivering incidence than the group C...The difference was statistically significant (P<0.05). The Ramsey sedation score (RSS) was higher in group D than in group T after injection (P<0.05) and the side effect rate in group D was lower than that in group T. Conclusion〓Dexmedetomidine and tramadol may be effective in preventing shivering during spinal and epidural anesthesia...The former showed more results in reducing the incidence of side effects and increasing the Ramsay sedation score.

Key words: Dexmedetomidine, Tramadol, Spinal and epidural anesthesia, Shivering

摘要： 【摘要】〓目的〓比较右美托咪定与曲马多在防治腰硬联合麻醉下行下肢手术术中寒战的发生率及镇静程度。方法〓选择ASAⅠ~Ⅱ级择期经腰硬联合麻醉行下肢手术患者60例,随机分成3组:右美托咪定组(D组)采用静脉推注0.5 ?滋g/kg的右美托咪定),曲马多组(T组)静脉推注2 mg/kg的曲马多,空白对照组(C组)静脉推注等量生理盐水,3组均在实施腰硬联合麻醉前10 min内给完所需药量,比较三组患者血流动力学的变化、寒战的发生率及镇静评分。结果〓与C组比较,D组和T组均能降低患者寒战的发生率,差异有统计学意义(P<0.05);与T组比较,D组使用的右美托咪定能提高患者的镇静评分,且无恶心呕吐等不良反应的发生。结论〓右美托咪定与曲马多在腰硬联合麻醉前静脉泵注,能够有效降低寒战反应发生率,右美托咪定更能提高患者的镇静满意度,且无药物不良反应发生。

关键词: 右美托咪定, 曲马多, 腰硬联合麻醉, 寒战反应