术中输注舒芬太尼和瑞芬太尼对术后寒战的影响

背景与目的

目前比较舒芬太尼和瑞芬太尼相关术后寒战发生率的研究较少。本研究旨在比较择期手术患者使用舒芬太尼或瑞芬太尼全凭静脉麻醉后术后寒战的发生率。

方法

将ASA分级为I- II 级的83例择期手术患者随机分为瑞芬太尼-丙泊酚组(RP组，n=40)和舒芬太尼-丙泊酚组(SP组，n=43)。主要观察指标为进入恢复室后1h术后寒战的发生率。次要观察指标是麻醉诱导后30 min和手术结束时食管和鼓膜的术中核心温度。

结果  

RP组(15%)与SP组(11.6%)术后寒战总体发生率无显著性差异(P=0.651)。RP组与SP组食管远端和鼓膜的术中核心温度及其变化(诱导后30min体温减去术后体温)无显著性差异(P>0.05)。

结论

舒芬太尼组术后寒战发生率略低于瑞芬太尼组，但术中核心体温无显著差异。

原始文献来源及摘要

Jung KT, So KY, Jee IG, et al.  Effect of intraoperative infusion of sufentanil versus remifentanil on postoperative shivering in Korea: a prospective, double-blinded, randomized control study[J]. Turk J Med Sci 2020 Aug 16;48(4).DOI：10.3906/sag-1709-161.

Abstract

Background/aim: The number of published papers that compare the incidence of sufentanil- and remifentanil-related postoperative shivering is insufficient. We investigated the incidence of postoperative shivering after total intravenous anesthesia with either sufentanil or remifentanil in patients who underwent elective surgery.

Materials and methods: Eighty-three patients, with a physical status classified as American Society of Anesthesiologists I or II, were randomly allocated to either the remifentanil–propofol (RP group, n = 40) or sufentanil–propofol (SP group, n = 43) group. The primary endpoint was the incidence of postoperative shivering 1 h after entering the recovery room. The secondary endpoints were intraoperative core temperatures of the esophagus and tympanic membrane at 30 min after the induction of anesthesia and at the end of surgery.

Results: The overall postoperative shivering incidence was not significantly different between the RP (15%) and SP (11.6%) groups (P = 0.651). The intraoperative temperatures and their changes (the temperature 30 min after induction minus that after surgery) as measured at the distal esophagus and tympanic membrane were not significantly different between the RP and SP groups.

Conclusion: The incidence of postoperative shivering related to sufentanil was less than that related to remifentanil, with no significant differences in the intraoperative core temperatures.