Abstract：The occurrence of chills after spinal anesthesia is relatively common,mainly related to the inhibition of hypothalamic thermoregulation centers by anesthetic drugs,resulting in abnormal thermogenesis response.Chills not only cause discomfort and anxiety in patients,but can also increase the risk of complications,delay postoperative recovery,prolong hospital stay,and increase healthcare costs.In recent years,esketamine,as a dextrorotator of ketamine,has gained attention in perioperative management due to its unique pharmacological properties.Studies have shown that it may reduce the incidence of chills after neuraxial anesthesia by regulating body temperature regulation points or inhibiting the downward conduction of chills commands,and its psychomotor adverse effects are milder than ketamine.The purpose of this article is to review the current situation of chills after spinal anesthesia,explore the pharmacological properties of esketamine and its application in the prevention and treatment of chills,and evaluate its efficacy and safety,in order to provide reference for clinical practice.
王园园, 张蕾. 艾司氯胺酮防治椎管内麻醉后寒战的研究进展[J]. 哈尔滨医药, 2026, 46(2): 134-136.
Wang Yuanyuan, Zhang Lei. Research Progress on Esketamine in the Prevention and Treatment of Chills after Spinal Anesthesia. journal1, 2026, 46(2): 134-136.
[1] 吕秋玉.椎管内麻醉后寒战反应的临床相关影响因素探析[J].世界最新医学信息文摘,2016,16(63):89,92. [2] 王海燕,黄月伟,高特生.艾司氯胺酮诱导预防烧伤患者术后寒战的研究[J].浙江医学,2023,45(3):281-283. [3] 宋婉雪,李盈科.艾司氯胺酮的临床应用研究进展[J].医学综述,2023,29(19):3942-3947. [4] 余凤仙,李晓霞.艾司氯胺酮在妇产科病人中的临床应用进展[J].临床医学进展,2023,13(2):1574-1580. [5] 张小蝶,蔡彬彬,胡瑶琴.艾司氯胺酮在儿科手术室外麻醉中的研究进展[J].浙江医学,2024,46(6):648-651. [6] Wan JX,Li XC,Zeng SS,et al.Comparison of intravenous butorphanol vs.tramadol for post-spinal anesthesia shi-vering:a meta-analysis and systematic review.Frontiers in medicine,2023,10:1271664. [7] Goich K,Pastore D,Koutsenko B,et al.A Scoping Review:Ketamine for the Prevention of Perioperative Shivering in Patients Undergoing Spinal Anesthesia[J].Cureus,2024,16(8):e66630. [8] Sessler DI,Rubinstein EH,Moayeri A.Physiologic responses to mild perianesthetic hypothermia in humans.Anesthe-siology.1991 Oct;75(4):594-610. [9] Thangavelu,Ramyavel#magtechI#,et al.Prophylactic low dose ketamine infusion for prevention of shivering during spinal anes-thesia:A randomized double blind clinical trial.Journal of anaesthesiology,clinical pharmacology,2020,36(4):506-510. [10] Honarmand A,Safavi MR.Comparison of prophylactic use of midazolam,ketamine,and ketamine plus midazolam for prevention of shivering during regional anaesthesia:a randomized double-blind placebo controlled trial.British journal of anaesthesia,2008,101(4):557-562. [11] Kose EA,Honca M,Dal D,et al.Prophylactic ketamine to prevent shivering in parturients undergoing Cesarean delivery during spinal anesthesia.Journal of clinical anesthesia,2013,25(4):275-280. [12] Aboelsuod MAA,Elnaggar AMA,Alwafa TAAA,et al.Effect of Intravenous Ketamine Infusion on Hemodynamics of Patients Undergoing Cesarean Delivery after Spinal Anaesthesia:A Randomized,Double-Blind,Controlled Trial.Turkish journal of anaesthesiology and reanimation,2023,51(5):420-426. [13] 许德芳. 低剂量艾司氯胺酮预防剖宫产产妇椎管内麻醉后寒战的效果[J].医疗装备2022,35(15):75-77+80. [14] 王宇,崔宇,唐莉,等.不同剂量氯胺酮在预防产科患者椎管内麻醉后寒战中的作用[J].四川医学,2018,39(07):755-757. [15] 周辉,宋水涛.前列腺电切术后寒战的危险因素分析及防治策略研究[J].黑龙江医学,2024,48(23):2835-2838. [16] Gemechu AD,Gebremedhin TD,Andebiku AA,et al.The effect of ketamine versus tramadol on prophylactic post-spinal shivering in those patients undergoing orthopedic surgery:a prospective cohort study design,2020.BMC Anesthesiol,2022,22(1):361. [17] Barrett W,Buxhoeveden M,Dhillon S.Ketamine:a versatile tool for anesthesia and analgesia.Curr Opin Anaesthe-siol,2020,33(5):633-638. [18] De Witte J,Sessler DI.Perioperative shivering:physiology and pharmacology.Anesthesiology,2002,96(2):467-484. [19] Khan T,Yadav M,Geetha S,et al.Comparison between dexmedetomidine,ketamine and tramadol for prevention of perioperative shivering under spinal anaesthesia:a ran-domised clinical trial.J Clin Diagn Res,2022,16(12):32-36. [20] Kandi V,Vadakedath S.Clinical Trials and Clinical Research:A Comprehensive Review[J].Cureus,2023,15(2):e35077. [21] Purna Singh A,Shahapur PR,Vadakedath S,et al.Research Question,Objectives,and Endpoints in Clinical and Oncological Research:A Comprehensive Review[J].Cureus,2022,14(9):e29575. [22] Karkare S,Le HH,Sheehan JJ,et al.Pitfalls of Cost-Effectiveness Analysis in Practice:A TRD Case Exam-ple in the United States with Esketamine Versus Oral Antidepressants[J].Journal of managed care & specialty pharmacy,2020,26(4):568-569.
2026, Vol. 46 
