在肥胖的选择性剖腹产患者中维持子宫度的催产素输液剂量反应:一项随机对照试验
Qin-Fang Yan1, Ling Ai1, Yi-Min Huang1
1Department of Obstetrics and Gynecology, Jiaxing Women and Children's Hospital of Wenzhou Medical University, Jiaxing, China.
Frontiers in pharmacology
|May 3, 2024
概括
接受剖腹产的肥胖妇女需要更高的催产素输液剂量来达到足够的子宫度. 在这个人群中,催产素输注的90%有效剂量 (ED90) 在初始玻尿酸注射后为19.1 IU/h.
科学领域:
- 产科和妇科 产科和妇科
- 麻醉学 麻醉学
- 药理学 药理学是指药理学的学科.
背景情况:
- 确立的催产素有效剂量 (ED90) 在剖腹产 (CD) 时.
- 对接受CD的肥胖女性进行最佳催产素输注的数据有限.
- 假设:超重的患者需要更高的催产素剂量来提高子宫度 (UT).
研究的目的:
- 在接受选择性CD的肥胖女性中确定催产素输注的剂量反应曲线.
- 评估一个1IU玻尿酸输注后的催产素输注的ED90.
- 评估最佳的预防性催产素剂量,以维持该人群的适当的尿道.
主要方法:
- 100名肥胖分娩妇女 (BMI > 30 kg/m2) 随机分配了催产素输注速率 (14,18,22,26 IU/h).
- 最初的1IU催产素玻尿酸注射.
- 足够的UT通过触觉触摸来定义 (像额头/鼻子一样硬).
- 通过探头分析确定中位有效剂量 (ED50) 和ED90.
主要成果:
- 催产素输注的ED50和ED90分别为大约11.0 IU/h和19.1 IU/h.
- 催产素的救援率有所不同:每小时14 IU (6 个患者),每小时18 IU (3 个患者),每小时22 IU (1 个患者),每小时26 IU (0 个患者).
- 在救援催产素频率和预防子宫的必要输液剂量之间存在显著的相关性 (p=0.02).
结论:
- 对于接受选择性CD的肥胖分娩者来说,催产素输注的ED90是19.1IU/h,其次是1IU的加载剂量.
- 肥胖患者需要更高的预防性催产素剂量.
- 需要进行进一步的研究,比较肥胖和不肥胖的患者.
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