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[摘要]目的：探討右美托咪啶在吸脂术中防治寒战的作用及适宜剂量。方法：将于本院行吸脂术的60例患者随机分为4组，即D1组15例，D2组15例，D3组15例，C组（对照组）15例。吸脂术中，所有患者均行硬膜外麻醉，在右美托咪啶用量上，D1组为1μg·kg-1·h-1，D2组为0.5μg·kg-1·h-1，D3组为0.3μg·kg-1·h-1，C组给予等容量生理盐水。观察4组患者麻醉期间寒战的发生率及发生程度，监测各组患者入室后5min（T0）、静脉给药后15min（T1）、30min（T2）、40min（T3）及60min（T4）对各时刻点上患者的心率（HR）、血压（BP）及血氧饱和度（SpO2）；同时，采用Ramsay评分标准对患者术中的麻醉镇静效果进行评价。结果：D1、D2、D3组患者术中寒战发生率均低于C组，差异具有统计学意义（P<0.05）；D1、D2、D3 三组间比较，差异无统计学意义（P>0.05）。相较于T0时刻，T1～T4时刻，D2、D3、C组三组间患者的HR、BP、 SpO2指标值均无明显波动（P>0.05）；但T2～T4时刻，D1组患者的HR指标值较T0时刻下降（P<0.05），BP指标值较T0时刻下降（P<0.05）。4组Ramsay平均评分比较，差异均无统计学意义（P>0.05）。结论：小剂量右美托咪啶在吸脂术中不仅能发挥良好的寒战防治作用，且对患者血流动力学的影响较小，可取得良好的镇静效果，值得临床推广应用。
[关键词]吸脂术；右美托咪啶；寒战；血流动力学；剂量
[中图分类号]R622 [文献标志码]A [文章编号]1008-6455（2017）09-0031-03
Observation of Shivering Preventing Effect of Dexmedetomidine in the Liposuction Surgery
CHEN Li，LI Yong-rong，CHENG Xi-xiong
（Department of Anesthesiology，Sichuan Huamei Zixin Medical Aesithetic Hospital，
Chengdu 610000，Sichuan，China）
Abstract： Objective To research the effect and appropriate dose of dexmedetomidine in the treatment of preventing shivering in the liposuction. Methods Randomly divided the patients of our hospital ready to liposuction surgery into 4 groups， D1 group（n=15 cases）， D2 group（n=15 cases）， D3 group（n=15 cases）， C group is control group（n=15 cases）. All the patients were anaesthetized by epidural anesthesia in liposuction surgery. The dexmedetomidine dose of D1 group was 1μg·kg-1·h-1， D2 group was 0.5μg·kg-1·h-1， D3 group was 0.3μg·kg-1·h-1， C group were treated by normal saline of the same volume. Compare the shivering incidence and degree of 4 groups during anesthesia period. Monitor the HR， BP and SpO2 of five minutes after entering room（T0）， 15 minutes after intravenous administration （T1）， 30 minutes（T2）， 40 minutes（T3） and 60 minutes（T4）. Evaluate the sedative effect during operation by Ramsay grading standard. Results The incidence of intraoperative shivering of D1、D2、D3 groups were lower than C group（P<0.05）， between the D1， D2 and D3 groups ， the difference had no statistical difference（P>0.05）. The HR， BP， SpO2 of T1-T4 of D2、D3、C had no obvious fluctuation with T0 time（P>0.05）. HR of D1 group at T2-T4 time were lower than T0（P<0.05）， BP was lower too（P<0.05）. The Ramsay average score of 4 groups had no statistical difference（P>0.05）. Conclusion Small dose of dexmedetomidine can not only play a good role in the prevention of shivering in liposuction ， and the effects on hemodynamics in patients with less desirable good sedative effect， it is worthy of clinical promotion.
[关键词]吸脂术；右美托咪啶；寒战；血流动力学；剂量
[中图分类号]R622 [文献标志码]A [文章编号]1008-6455（2017）09-0031-03
Observation of Shivering Preventing Effect of Dexmedetomidine in the Liposuction Surgery
CHEN Li，LI Yong-rong，CHENG Xi-xiong
（Department of Anesthesiology，Sichuan Huamei Zixin Medical Aesithetic Hospital，
Chengdu 610000，Sichuan，China）
Abstract： Objective To research the effect and appropriate dose of dexmedetomidine in the treatment of preventing shivering in the liposuction. Methods Randomly divided the patients of our hospital ready to liposuction surgery into 4 groups， D1 group（n=15 cases）， D2 group（n=15 cases）， D3 group（n=15 cases）， C group is control group（n=15 cases）. All the patients were anaesthetized by epidural anesthesia in liposuction surgery. The dexmedetomidine dose of D1 group was 1μg·kg-1·h-1， D2 group was 0.5μg·kg-1·h-1， D3 group was 0.3μg·kg-1·h-1， C group were treated by normal saline of the same volume. Compare the shivering incidence and degree of 4 groups during anesthesia period. Monitor the HR， BP and SpO2 of five minutes after entering room（T0）， 15 minutes after intravenous administration （T1）， 30 minutes（T2）， 40 minutes（T3） and 60 minutes（T4）. Evaluate the sedative effect during operation by Ramsay grading standard. Results The incidence of intraoperative shivering of D1、D2、D3 groups were lower than C group（P<0.05）， between the D1， D2 and D3 groups ， the difference had no statistical difference（P>0.05）. The HR， BP， SpO2 of T1-T4 of D2、D3、C had no obvious fluctuation with T0 time（P>0.05）. HR of D1 group at T2-T4 time were lower than T0（P<0.05）， BP was lower too（P<0.05）. The Ramsay average score of 4 groups had no statistical difference（P>0.05）. Conclusion Small dose of dexmedetomidine can not only play a good role in the prevention of shivering in liposuction ， and the effects on hemodynamics in patients with less desirable good sedative effect， it is worthy of clinical promotion.