[Intramuscular meperidine for the prevention of shivering in spinal anesthesia].

L H Hu, J C Chen, Y Lee, K B Lai, K L Wong, T T Wei
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Abstract

Intravenous meperidine 25mg has been employed effectively to treat shivering following regional anesthesia and general anesthesia. The study was designed to evaluate the effectiveness of intramuscular meperidine for the prevention of shivering in spinal anesthesia. The series consisted of 60 patients who were divided into 2 groups with 30 patients in each, undergoing lower abdominal or lower extremity surgery. All patients were given diazepam 0.1mg/kg i.v. for anxiolysis when they came to the operating room. In a double blind and randomized fashion, patients in the study (meperidine) group received meperidine 25mg IM (= 0.5ml). In the control group 0.9% N/S 0.5ml IM was given instead. All patients received spinal anesthesia 15 minutes later. Measurement of the levels of sensory loss to pinprick was made. The ambient temperature and the rectal temperature were continuously monitored to evaluate the effect of the change in body temperature on shivering during operation. The degree and the occurrence of shivering were carefully evaluated and recorded by a blind-trust observer. There was no significant difference in maximal analgesic level, ambient temperature and change of rectal temperature during operation between the groups. Shivering occurred in 17 patients (56.7%) in the saline group with an onset time of 7.9 +/- 2.5min following spinal anesthesia. In the meperidine group, shivering occurred only in 3 patients (10%) with an onset time of 54 +/- 29.5min after spinal anesthesia. There was a significantly lower incidence of shivering in the meperidine group than in the saline group (p < 0.005).(ABSTRACT TRUNCATED AT 250 WORDS)

脊柱麻醉中肌内注射亚立啶预防寒战。
静脉注射哌替啶25mg可有效治疗局部麻醉和全身麻醉后的寒战。本研究旨在评估肌注哌替啶预防脊髓麻醉中寒战的有效性。该系列包括60例患者,分为2组,每组30例,接受下腹部或下肢手术。所有患者入手术室时均给予地西泮0.1mg/kg静脉注射抗焦虑药。采用双盲随机法,研究组(甲哌啶组)患者给予甲哌啶25mg IM (= 0.5ml)。对照组以0.9% N/S 0.5ml IM代替。15分钟后,所有患者接受脊髓麻醉。测定针刺后感觉丧失程度。连续监测环境温度和直肠温度,评价体温变化对术中寒战的影响。颤抖的程度和发生由一个盲目信任的观察者仔细评估和记录。两组患者术中最大镇痛水平、环境温度及直肠温度变化无显著差异。生理盐水组有17例(56.7%)患者出现寒战,发病时间为脊髓麻醉后7.9±2.5min。在哌替啶组中,仅有3例(10%)患者出现寒战,发生时间为脊髓麻醉后54±29.5min。哌哌啶组寒战发生率明显低于生理盐水组(p < 0.005)。(摘要删节250字)
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