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首页> 外文期刊>Stroke: A Journal of Cerebral Circulation >Dexmedetomidine and meperidine additively reduce the shivering threshold in humans.
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Dexmedetomidine and meperidine additively reduce the shivering threshold in humans.

机译：右美托咪定和哌替啶可共同降低人体的寒战阈值。

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BACKGROUND AND PURPOSE: Hypothermia might prove to be therapeutically beneficial in stroke victims; however, even mild hypothermia provokes vigorous shivering. Meperidine and dexmedetomidine each linearly reduce the shivering threshold (triggering core temperature) with minimal sedation. We tested the hypothesis that meperidine and dexmedetomidine synergistically reduce the shivering threshold without producing substantial sedation or respiratory depression. METHODS: We studied 10 healthy male volunteers (18 to 40 years) on 4 days: (1) control (no drug); (2) meperidine (target plasma level 0.3 microg/mL); (3) dexmedetomidine (target plasma level 0.4 ng/mL); and (4) meperidine plus dexmedetomidine (target plasma levels of 0.3 microg/mL and 0.4 ng/mL, respectively). Lactated Ringer's solution (approximately 4 degrees C) was infused through a central venous catheter to decrease tympanic membrane temperature by approximately 2.5 degrees C/h; mean skin temperature was maintained at 31 degrees C. An increasein oxygen consumption >25% of baseline identified the shivering threshold. Sedation was evaluated by using the Observer's Assessment of Sedation/Alertness scale. Two-way repeated-measures ANOVA was used to identify interactions between drugs. Data are presented as mean+/-SD; P<0.05 was statistically significant. RESULTS: The shivering thresholds on the study days were as follows: control, 36.7+/-0.3 degrees C; dexmedetomidine, 36.0+/-0.5 degrees C (P<0.001 from control); meperidine, 35.5+/-0.6 degrees C (P<0.001); and meperidine plus dexmedetomidine, 34.7+/-0.6 degrees C (P<0.001). Although meperidine and dexmedetomidine each reduced the shivering threshold, their interaction was not synergistic but additive (P=0.19). There was trivial sedation with either drug alone or in combination. Respiratory rate and end-tidal Pco2 were well preserved on all days. CONCLUSIONS: Dexmedetomidine and meperidine additively reduce the shivering threshold; in the small doses tested, the combination produced only mild sedation and no respiratory toxicity.
机译：背景与目的：体温过低可能被证明对中风患者有益。但是，即使是低温，也会引起剧烈的发抖。哌替啶和右美托咪定各自以最少的镇静作用线性降低发抖阈值（触发核心温度）。我们检验了以下假设，即哌替啶和右美托咪定协同降低发抖阈值而不会产生明显的镇静作用或呼吸抑制。方法：我们在4天研究了10名健康的男性志愿者（18至40岁）：（1）对照（无药物）; （2）哌替啶（目标血浆水平0.3微克/毫升）; （3）右美托咪定（目标血浆水平0.4 ng / mL）; （4）哌替啶加右美托咪定（目标血浆水平分别为0.3 microg / mL和0.4 ng / mL）。通过中央静脉导管注入乳酸林格氏液（约4摄氏度），以使鼓膜温度降低约2.5摄氏度/小时;平均皮肤温度维持在31摄氏度。耗氧量增加超过基线的25％确定了发抖阈值。使用观察者的镇静/警戒评估量表评估镇静。使用双向重复测量方差分析（ANOVA）来识别药物之间的相互作用。数据表示为平均值+/- SD; P <0.05具有统计学意义。结果：研究日的颤抖阈值如下：对照，36.7 +/- 0.3摄氏度;右美托咪定，36.0 +/- 0.5摄氏度（与对照组相比，P <0.001）;哌替啶，35.5 +/- 0.6摄氏度（P <0.001）;和哌替啶加右美托咪定，温度为34.7 +/- 0.6摄氏度（P <0.001）。尽管哌替啶和右美托咪定各自降低了颤抖阈值，但它们之间的相互作用不是协同作用而是加和作用（P = 0.19）。单独或联合使用药物均会产生镇静作用。呼吸速率和潮气末Pco2整天保存良好。结论：右美托咪定和甲哌丁啶相加可降低颤抖阈值。在小剂量试验中，该组合仅产生轻度镇静作用，而没有呼吸道毒性。

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