Clinical Observasion Of Dxmedetomidine For Prevention Of Shivering After Combined Spinal-epidural Anesthsia In Patients Undergoing Cesarean Section

Objective:To explore the preventive effects of dexmedetomidine hydrochloride for shivering after combined spinal-epidural anesthesia in patients with cesarean section.Methods:A total of 100 patients with cesarean section under combined spinal-epidural anesthesia were randomly selected from our hospital.Inclusion criteria:20-35 years old;ASA I-II grade;first pregnancy;singleton;body weight of 60-90kg.The patients were randomly divided into control group and experimental group.The patients were laid in left supine position,and spinal needle was used to pierce through duro mater spinalis in L_3-4 clearance.Once clear cerebrospinal fluid flowed out,10-15mg of 0.75%ropivacaine hydrochloride was injected slowly.Epidural catheter was indwelled in epidural region.The patients were laid in prostration without pillow after anesthesia.T6 was controlled at the upper end of block plane.Intravenous pumping of 0.5?g/kg of dexmedetomidine?load dosage?was carried out for 15 min from the moment of bolus injection of ropivacaine in the experimental group,while bolus injection of same amount of normal saline was performed in the control group.The two groups were observed and recorded cycle changes,intraoperative Wrench shiver scores,and Ramsay sedation scores before anesthesia?T₀?,5 min?T₁?and 10min?T₂?after anesthesia,infant birth?T₃?,15 min?T₄?and 30 min?T₅?after anesthesia,and at the end of surgery?T₆?,as well as neonatal Apgar scores at 1 min,5min and 10min after infant birth.The two groups were observed and recorded for the operation time,intraoperative transfusion amount,intraoperative blood loss and intraoperative application of methamphetamine and atropine.Results:1.There were no statistically significant differences between two groups in age,body weight,body height,operation time,intraoperative blood loss and intraoperative transfusion amount,etc.?P>0.05?.2.Apgar scores of two groups of newborns were all above 8 points at birth, and greater than 10 points 5 min after birth,without significance?P>0.05?.3.There were no differences between two groups in MAP and HR at T₀. Compared with T₀,blood pressure at T_1-3 was stable in the experimental group,without statistical significance?P>0.05?;MAP was decreased in the control group at T_1-3,and the difference was of statistically significant?P<0.05?.HRs at T_2-6 were all lower in the experimental group than the control group?P<0.05?.And there were no statistically significant differences between two groups in SpO₂?P>0.05?.4.The incidence and degree of shivering in the experimental group were lower than the control group?14%vs.40%?,with statistically significant differences?P<0.05?.5.There were no significant differences between two groups in Ramsay scores.1case appeared sleep state and could be evoked in the experimental group.No patients appeared respiratory depression due to excessive sedation.There were no statistically significant differences between two groups in adverse reactions after medication.Conclusions:1.Pre-injection of 0.5?g/kg of dexmedetomidine can effectively reduce the shivering during CSEA,provide satisfactory sedative effects,maintain stable hemodynamics,and has no obvious effects on breathing.2.Pre-injection of 0.5?g/kg of dexmedetomidine has no significanteffects on uterine smooth muscles and neonatal Apgar scores.