Dezocine Butorphanol Combined With Midazolam In Prevention And Treatment Of Shivering During Cesarean Section And Postoperative

Objective The percentage of cesarean section is rising each year,and intraspinal anesthesia was applied widely as the special physiological reasons of the gravida.Shivering,which the occurrence rate is up to 5%~65%,is one of the common complications of cesarean delivery.The appearance of intraoperative shivering could cause a series of reactions in maternal,such as pain,discomfort and enhancement of metabolism etc.So it's adverse for anesthesiologists to observe the physiological indexes of puerperas accurately and surgeons to carry the operation successfully.Many drugs,for example ketamine and fentanyl,have been tried for the above difficulties,but they were all failed with the reasons of single effect or severe adverse reactions etc.Our trail focused on the preventive and therapeutic effect of dezocine,butorphanol combined with midazolam for shivering occurred in Intraoperative and postoperative of cesarean section.And then,we could choose an effective method to prevent and cure shivering,to set up a comprehensive of plan to shivering.Methods The patients,who accepted cesarean section in maternal and child care service centre of Liaocheng from July 2015 to July 2016,were recruited in our study.According to the included and excluded criteria,we carried the first screening.Afterwards,the recruiters were randomly divided into prevention group(100 cases,drugs were intravenous administrated after fetal delivery immediately)and treatment group(100 cases,drugs were intravenous administrated after fetal delivery when shivering appears).Then,prevention group was further randomly divided into ? group(50 cases,0.1mg/kg dezocine + 0.03mg/kg midazolam)and ? group(50 cases,0.01mg/kg butorphanol + 0.03mg/kg midazolam).And treatment group was also randomly divided into ? group(50 cases,0.1mg/kg dezocine + 0.03mg/kg midazolam)and ? group(50 cases,0.01mg/kg butorphanol + 0.03mg/kg midazolam).Many indexes(mean arterial pressure(MAP),heart rate(HR),respiratory rate(RR),shivering classification,effect of eliminating shivering,draw reaction classification,Rasmay sedation score and others)were detected in different time(Into the operating room—T0,pre-administration—T1,post-administration 3 min—T2,5 min—T3,10 min—T4,30 min—T5 and 1 h—T6)to summarize an optimized plan in prevention and treatment of shivering.Results (1) In the intra-group comparison of prevention and treatment group,there was no statistically difference of the baseline information(P>0.05).(2) In the ? group,MAP was slightly lower in T4 time-point(P<0.05),but it didn't show statistically significant difference in other time-point of prevention group and every time-point of treatment group(P> 0.05).(3) In both the two groups,HR didn't show statistically significant difference in every time-point(P>0.05).(4) Concerning of respiratory function,there was no statistically significant difference in every time-point of two groups(P>0.05).(5) In preventing chill,there was no significant difference in prevention group(P>0.05).In treating shivering,the ? group is significant faster to elimate shivering than ? group(P<0.01);but there was no significant difference in total effective rate(P>0.05).(6) The drugs for draw reaction,the effect is more evident in ? group of preventive administration(P<0.01).However,there was no distinct difference in the treatment group(P>0.05).(7) In the ? group of preventing administration,Rasmay sedation score was increased in T3 and T5 time-point(P < 0.05)and elevated markedly in T4 time-point(P<0.01).And in the ? group of therapeutic medication,it was rised in T2 time-point(P<0.05).Conclusions In prevention of shivering,both the two kinds of drug combination have obvious curative effect,but for controlling of draw reaction and drowsiness,the dezocine + midazolam group was better than the combination of butorphanol + midazolam.In treatment of shivering,butorphanol + midazolam group cost less time to eliminate shivering than the dezocine + midazolam group.So the combination of dezocine + midazolam was recommended for preventing shivering,and the combination of butorphanol + midazolam was recommended for treating shivering.