کنترل لرز در زنان تحت بیحسی اسپاینال: یک مطالعه مروری نقلی در مورد نقش داروها

نوع مقاله : مروری

نویسندگان

1 استادیار گروه بیهوشی و مراقبت‌های ویژه، مرکز تحقیقات بیهوشی، مراقبت‌های ویژه و کنترل درد، دانشگاه علوم پزشکی هرمزگان، بندرعباس، ایران.

2 استادیار گروه زنان و مامایی، مرکز تحقیقات سلامت و بیماری‌های زنان، دانشکده پزشکی، دانشگاه علوم پزشکی جهرم، جهرم، ایران.

3 کارشناس ارشد مراقبت‌های ویژه نوزادان، دانشکده پرستاری و مامایی حضرت فاطمه (س)، دانشگاه علوم پزشکی شیراز، شیراز، ایران.

4 استادیار گروه جراحی، دانشکده پزشکی، دانشگاه علوم پزشکی جهرم، جهرم، ایران.

5 استادیار گروه طب اورژانس، دانشگاه علوم پزشکی جهرم، جهرم، ایران.

6 استادیار گروه فارماکولوژی، دانشکده پزشکی، دانشگاه علوم پزشکی گیلان، گیلان، ایران.

7 مربی گروه هوشبری، مرکز تحقیقات مؤلفه‌های اجتماعی نظام سلامت، دانشکده پزشکی، دانشگاه علوم پزشکی جهرم، جهرم، ایران.

8 دانشجوی پزشکی، کمیته تحقیقات دانشجویی، دانشکده پزشکی، دانشگاه علوم پزشکی جهرم، جهرم، ایران.

9 استادیار گروه بیهوشی و مراقبت‌های ویژه، دانشکده پزشکی، دانشگاه علوم پزشکی شیراز، شیراز، ایران.

چکیده

مقدمه: پیشگیری و کنترل لرز مادر طی بی­حسی نخاعی جهت عمل جراحی سزارین اهمیت بالایی در پیامد­های مناسب عمل جراحی دارد، با این‌حال انتخاب داروی مناسب جهت این امر باید با عوارض کمی برای مادر و نوزاد همراه باشد، لذا مطالعه حاضر با هدف بررسی داروهای استفاده شده در کنترل لرز در زنان تحت بی­حسی اسپاینال صورت گرفت.
روش‌کار: در این مطالعه مروری نقلی جهت یافتن مطالعات مرتبط، جستجوی کامپیوتری در پایگاه­های اطلاعاتی SID، Magiran و Google Scholar با کلید واژه‌های فارسی شامل: بی­حسی اسپاینال، لرز و سزارین انجام شد. در مرحله اولیه جستجوی مطالعات، 364 مطالعه بررسی گردید که تعداد 341 مطالعه به‌دلیل مرتبط نبودن با موضوع مورد مطالعه حذف گردید. در نهایت 13 مطالعه جهت نگارش این مطالعه استفاده گردید.
یافته‌ها: در مرور پیشینه پژوهش، مطالعات مختلف از داروهای متفاوتی جهت پیشگیری از لرز پس از عمل جراحی سزارین استفاده کرده بودند. لرز پس از بی­حسی نخاعی، هدف اختصاصی مطالعات بسیار زیادی با طراحی کارآزمایی بالینی بود. مداخلات انجام شده در این راستا شامل: استفاده از تزریق داخل نخاعی یا وریدی دارو­هایی مانند سولفات منیزیم، هیدروکورتیزون، دگزامتازون، اندانسترون، کتامین، میدازولام، کتامین به‌همراه میدازولام بود. داروهای اپیوئیدی مانند فنتانیل، ترامادول و پتدین نیز در برخی مطالعات مورد بازبینی قرار گرفته بودند.
نتیجه‌گیری: بر اساس مطالعات مختلف صورت گرفته به‌نظر می‌رسد پتدین با مکانیسم نامشخص و احتمالی گیرنده‌های μ، بهترین دارو در کنترل لرز در عمل جراحی سزارین باشد.

کلیدواژه‌ها

عنوان مقاله [English]

Shivering control in women under spinal anesthesia: A narrative review on the role of drugs

نویسندگان [English]

  • Mehrdad Malekshoar 1
  • Majid Vatankhah 1
  • Athar Rasekh Jahromi 2
  • Hamed Ghasemloo 3
  • Farideh Mogharab 2
  • Mojtaba Ghaedi 4
  • Samaneh Abiri 5
  • Lohrasb Taheri 4
  • Davoud Roostaei 6
  • Navid Kalani 7
  • Naser Hatami 8
  • Seyed Ebrahim Sadeghi 9
1 Assistant professor, Department of Anesthesiology and Critical Care, Anesthesiology & Critical Care and Pain Management Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran.
2 Assistant professor, Department of Obstetrics and Gynecology, Women's Health and Diseases Research Center, Faculty of Medicine, Jahrom University of Medical Sciences, Jahrom, Iran.
3 M.Sc. of Neonatal Intensive Care, Hazrate Fatemeh School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran.
4 Assistant professor, Department of Surgery, Faculty of Medicine, Jahrom University of Medical Sciences, Jahrom, Iran.
5 Assistant professor, Department of Emergency Medicine, Jahrom University of Medical sciences, Jahrom, Iran.
6 Assistant Professor, Department of Pharmacology, Faculty of Medicine, Guilan University of Medical Sciences, Guilan, Iran.
7 Instructor, Department of Anesthesia, Research Center for Social Determinants of Health, Faculty of Medicine, Jahrom University of Medical Sciences, Jahrom, Iran.
8 Medical Student, Student Research Committee, Faculty of Medicine, Jahrom University of Medical Sciences, Jahrom, Iran.
9 Assistant Professor, Department of Anesthesiology and Critical Care, Faculty of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.
چکیده [English]

Introduction: Prevention and control of maternal shivering during spinal anesthesia for cesarean section is very important in the appropriate outcomes of surgery; however, choosing the appropriate drug for this issue should be associated with few side effects for mother and baby. Therefore, this study was performed with aim to evaluate the drugs used to control shivering in women under spinal anesthesia.
Methods: In this narrative review study, to find the related studies, computer search was performed in databases of SID, Magiran and Google Scholar with Persian keywords of spinal anesthesia, shivering and cesarean section. In the initial stage of searching, 364 studies were reviewed and 341 studies were deleted due to not being related to the subject. Finally, 13 studies were used to write this study.
Results: In reviewing the research background, different studies had used different drugs to prevent shivering after cesarean section. Shivering after spinal anesthesia has been the specific goal of many studies with clinical trial design. Performed interventions in this regard included: intrathecal or intravenous injection of drugs such as magnesium sulfate, hydrocortisone, dexamethasone, ondansetron, ketamine, midazolam, ketamine with midazolam. Opioid drugs such as fentanyl, tramadol, and pethidine have also been reviewed in some studies.
Conclusion: Based on various studies, pethidine with unknown and possible mechanism of μ receptors seems to be the best drug in control of Shivering in cesarean section.

کلیدواژه‌ها [English]

  • Cesarean section
  • Shivering
  • Spinal anesthesia

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