上腺素与上腺素输液用于预防在剖腹产时脊椎麻醉后对母亲的低血压的预防:一项随机对照试验
Yasmin S Hassabelnaby1, Ahmed M Hasanin2, Mohamed Shamardal1
1Department of Anesthesia and Critical Care Medicine, Cairo University, Cairo, Egypt.
Journal of anesthesia
|May 24, 2024
概括
上腺素和上腺素输液在剖腹产中对母亲的血液动力学和新生儿结果产生了类似的影响. 与上腺素相比,上腺素与更高的高心率有关,但潜在的低血压可能较低.
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:
- 在剖腹产期间的脊髓麻醉会导致血液动力学变化.
- 血管活性药物,如上腺素和上腺素,用于管理这些变化.
- 对比低剂量的上腺素和上腺素输液对于优化孕产妇和新生儿安全至关重要.
研究的目的:
- 为了比较低剂量上腺素和上腺素输注的血液动力学效应.
- 评估母亲的综合结局,包括低血压,高血压,心和心动减速.
- 评估新生儿结局,如动脉血气和Apgar分数等.
主要方法:
- 一个随机对照试验,涉及到经过选择性剖腹产的全程孕妇.
- 参与者接受了连续注射上腺素 (0.03 毫克克/公斤/分钟) 或上腺素 (0.4 毫克克/公斤/分钟) 后脊椎麻醉.
- 主要结局:低血压,高血压,心和/或心动减速的组合;次要结局:新生儿评估.
主要成果:
- 每组98名患者;综合结果相似 (31%对32%,P=0.877).
- 上腺素组显示低血压的发生率可能较低 (P=0.066) 和低血压事件较少.
- 上腺素组有较高的心动减速发病率,而高血压和心是可比的;新生儿的结局是相似的.
结论:
- 上腺素和上腺素输注在剖腹产中产生可比的孕产妇血液动力学和新生儿结果.
- 上腺素的使用与孕产妇心率的增加和潜在的孕产妇低血压的降低有关.
- 这两种药物都是可行的选择,需要考虑不同的副作用概况.
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