بررسی مقایسه‌ای سه روش پروفیلاکسی استفاده از داروهای دگزامتازن، پتیدین و هیوسین وریدی بر روی لرز پس از عمل جراحی به دنبال بیهوشی عمومی

نوع مقاله : مقاله های پژوهشی

نویسندگان

1 دانشیار، مرکز تحقیقات بیهوشی و مراقبتهای ویژه، دانشگاه علوم پزشکی اصفهان، اصفهان، ایران

2 دانشجوی پزشکی، دانشکده‌ی پزشکی و کمیته‌ی تحقیقات دانشجویی، دانشگاه علوم پزشکی اصفهان، اصفهان، ایران

چکیده

مقدمه‌: پیش‌گیری و کنترل لرز پس از عمل جراحی از اهمیت قابل توجهی برخوردار است؛ روش‌های مختلی بدین منظور مورد استفاده قرار می‌گیرد. در این تحقیق، به بررسی مقایسه‌ای سه داروی دگزامتازون، پتیدین و هیوسین در پیش‌گیری از بروز لرز پس از عمل جراحی پرداخته شد.روش‌ها: در این تحقیق کارآزمایی بالینی، 90 بیمار کاندید عمل جراحی کله‌سیستکتومی ار طریق لاپاروسکوپی، به طور تصادفی به 3 گروه مساوی تقسیم‌بندی شدند. در گروه اول mg/kg 5/0 پتیدین، در گروه دومmg/kg  1/0دگزامتازون و در گروه سوم mg/kg 15/0 هیوسین مورد استفاده قرار گرفت و شیوع لرز پس از عمل جراحی و شدت آن در سه گروه بررسی و مقایسه شد. داده‌های مطالعه با استفاده از نرم‌افزار SPSS تجزیه و تحلیل آماری شد.یافته‌ها: در سه گروه پتیدین، هیوسین و دگزامتازون به ترتیب 0/60، 3/43 و 4/54 درصد افراد فاقد لرز بودند. همچنین، در این سه گروه به ترتیب، 0/20، 3/13 و 3/23 درصد بیماران لرز خفیف، 7/16، 3/33 و 7/6 درصد افراد لرز متوسط و 3/3، 0/10 و 0/10 افراد لرز شدید داشتند. شدت لرز در سه گروه اختلاف معنی‌داری نداشت (16/0 = P). استفاده از پتیدین باعث کاهش معنی‌دار در شدت درد بعد عمل شد و دو داروی هیوسین و دگزامتازون بر کاهش شدت تهوع و مصرف متوکلوپرامید، تأثیر مطلوب‌تری نسبت به پتیدین داشتند.نتیجه‌گیری: سه داروی پتیدین، هیوسین و دگزامتازون تفاوت قابل توجهی در کاهش بروز لرز بعد عمل ندارند ولی در کنترل سایر عوارض، متفاوتند. پیشنهاد می‌گردد، در مطالعات بعدی، تأثیر ترکیبی داروهای مذکور بر عوارض بعد عمل در بیماران تحت اعمال جراحی مورد مطالعه قرار گیرد.

کلیدواژه‌ها


عنوان مقاله [English]

Comparing Three Methods of Dexamethasone, Pethidine and Hyoscine in Prophylaxis of Postoperative Shivering after General Anesthesia

نویسندگان [English]

  • Morteza Heidari 1
  • Gholamreza Khalili 1
  • Ehsan Zolfi 2
1 Associate Professor, Anesthesiology and Critical Care Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
2 Student of Medicine, School of Medicine AND Student Research Committee, Isfahan University of Medical Sciences, Isfahan, Iran
چکیده [English]

Background: Prevention and control of shivering after surgery is of significant importance and different methods are used for this purpose. In this study, three drugs of dexamethason, petidine and hyoscine were compared in the prevention of postoperative shivering.Methods: In a clinical trial study, 90 patients who were candidates for laparascopic cholesistectomia were selected and randomly divided in three equal groups. The first group received 0.5 mg/kg pethidine, the second group 0.1 mg/kg dexamethason and the third group 0.15 mg/kg hyoscine. The prevalence of postoperative shivering was compared between the three groups. The data was analyzed using SPSS software.Findings: In three groups of pethidine, hyoscine and dexamethason, 60%, 43.3% and 54.4% had no postoperative shivering, respectively. In these groups, 20.0%, 13.3% and 23.3% had mild shivering, 16.7%, 33.3% and 6.7% had moderate shivering and 3.3.%, 10.0% and 10.0% had sever postoperative shivering, respectively, and no statistically difference were seen between the three groups (P = 0.16). Pain was lower in pethidine group than the other groups. In addition, dexamethasone and hyoscine had positive effects of postoperative nausea and methoclopramide consumption.Conclusion: Three drugs of pethidine, hyoscine and dexamethason have not different effects of prevention of postoperative shivering but the complications such were different. We recommend that in future studies, the combined effect of these drugs on postoperative complications in patients undergoing surgical procedures could be studied.

کلیدواژه‌ها [English]

  • Postoperative shivering
  • Pethidine
  • Hyoscine
  • Dexamathasone
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دوره 33، شماره 341 - شماره پیاپی 341
مرداد و شهریور 1394
صفحه 1044-1056
  • تاریخ دریافت: 19 فروردین 1394
  • تاریخ بازنگری: 04 مهر 1402
  • تاریخ پذیرش: 17 فروردین 1401
  • تاریخ اولین انتشار: 17 فروردین 1401