Tramadol Preconditioning Reduces Shivering After Combined Spinal And Epidural Anesthesia For Caesarean Section

objective:Comparison of the Tramadol Preconditioning preanesthesia and postanesthesia on the shiver which show up after the combined spinal epidural anesthesia in the caesarean section,so that we can give the reference to clinical working.Methods:Sixty ASAⅠorⅡpatients with uterogestation, scheduled for caesarean section under combined spinal epidural anesthesia were randomly allocated in 3 groups with 20 patients in each group: the first physiological saline group,administer physiological saline 5 minutes preanesthesia (n=20,groupⅠ),the first tramadol group,administer tramadol 1mg/kg 5 minutes preanesthesia (n=20,groupⅡ),the second physiological saline group,administer tramadol 1mg/kg postanesthesia immediately (n=20,groupⅢ).Set up the venous channel after come into the operating rooms, and administer the granisetron 3 mg intravenously guttae, and preconditioning hydroxyethyl starch 130/0.4 injection 500ml intravenously guttae 30 minites preanesthesia. Dilute the drugs of experiment into 20 ml in the corresponding time, administer it in nearly second minutes.Investigate the the HR,MAP,SPO2 at the time coming into the operating rooms,5minutes before the anesthesia,3minutes after the anesthesia , 5 minutes,10minutes,15minutes,20minutes after the anesthesia .Also record the maximal sensation blocking level and motion blocking level, the apgar score of neonate. Investigate that if there any complication ,such as nausea,vomiting, Dyspnea during , dizziness,et al, from preanesthesia to postoperation. Investigate the shivering status including the originated time ,lasting time and the severity until 2 hours after the operation.Results:There was no significant difference in the ages,body weight and the body height between the three groups (P>0.05),as well as the HR,MAP,SPO2 in each time of four groups, and the time between the spinal injection and the delivery(P>0.05) . All the Apgar scores of neonate are higher than 7,and there is no significant difference in the three groups(P>0.05).There was six shivering patients in group I , and one in the group III. Most of the shivering were happened in the 2～10 minute after the anesthesia.The shivering score of group I is higher than group II,III(P<0.05) ,and there is no significant difference between group IIand group III.The other complication between the three groups had no significant difference(P>0.05).Conclusion:Preconditioning of tramadol 5 minutes before the anesthesia and postanesthesia immediately are both effect to prevent the shivering during the combined spinal epidural anesthesia.