在选择性剖腹产期间,是否需要结晶体共载以防止脊柱低血压? 一个随机的双盲试验
B S Buddeberg1, E Seeberger2, C Bläsi2
1Clinic for Anaesthesia, Intermediate Care, Prehospital Emergency Medicine and Pain Therapy, University Hospital Basel, Switzerland; Department of Clinical Research, University of Basel, Switzerland.
International journal of obstetric anesthesia
|March 14, 2024
概括
在剖腹产脊髓麻醉期间省略液体负载,即使是用烯,心脏输出也会减少. 结晶体共载可能对孕产妇和新生儿的结果有益.
科学领域:
- 麻醉学 麻醉学
- 产科 产科 产科 产科 产科
- 心血管生理学心血管生理学
背景情况:
- 低血压是剖腹产期间脊柱麻醉的常见并发症.
- 液体加载和烯是常见的预防策略.
- 这项研究调查了与流体共同加载相比,省略液体加载,与预防性烯,是否保持心脏输出.
研究的目的:
- 确定在剖腹产脊柱麻醉期间保持心脏输出时,省略液体负荷是否与液体共负荷不逊色.
- 评估液体负载策略对心脏输出和其他孕产妇和新生儿结果的影响.
- 评估预防性费尼莱弗林输注与流体管理相关的作用.
主要方法:
- 随机试验涉及到经过选择性剖腹产的孕妇.
- 两个组:1L晶体共载与仅维护流体.
- 乙烯被用于维持血压;心脏输出变化是主要结果.
主要成果:
- 与共负荷组相比,无负荷组的心脏输出增加了33% .
- 在无负荷组中观察到,心脏输出减少了60%以上.
- 在没有负载的组中需要更高的烯剂量,这可能会对新生儿的酸状态产生负面影响.
结论:
- 在剖腹产脊髓麻醉期间,即使在使用烯酸,也会导致心脏输出量下降.
- 结晶体共载可能是有利的,可能会改善新生儿的酸状态.
- 在用于血压管理的费尼莱弗林输注时,建议同时加载液体.
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