在预防性北上腺素输注期间静脉注射初始玻尿酸,以预防剖腹产时的脊柱低血压:一种随机对照的剂量检测试验
Wenyuan Lyu1, Zheng Zhang2, Chengwei Li2
1Department of Anesthesiology, Qilu Hospital (Qingdao), Cheeloo College of Medicine, Shandong University, Qingdao, PR China.
Journal of clinical anesthesia
|July 24, 2024
概括
一个0.150μg/kg的初始玻尿酸有效地防止在剖腹产期间脊柱低血压. 这一剂量与连续输液相结合,可以减少恶心和吐,而不会增加高血压.
科学领域:
- 麻醉学 麻醉学
- 产科 产科 产科 产科 产科
- 药理学 药理学是指药理学的学科.
背景情况:
- 脊柱低血压是剖腹产期间常见的并发症.
- 上腺素输注可以降低低血压,但最优的初始玻尿酸剂量是未知的.
研究的目的:
- 为了确定在剖腹产期间预防脊柱低血压的最佳初始玻尿酸剂量.
主要方法:
- 这是一项随机对照试验,涉及120名分娩者.
- 四组接受了初始的诺拉上腺素玻尿酸剂量 (0,0.05,0.10,0.15μg/kg),然后进行0.05μg/kg/min输液.
- 主要结局:脊柱低血压的发生率;次要结局:恶心,吐,高血压,心肌梗塞,胎儿的阿帕格分数,带血气分析.
主要成果:
- 脊柱性低血压的发生率随着初始玻尿酸剂量增加而显著降低 (51.7%在0μg/kg组,6.9%在0.15μg/kg组).
- 有效剂量90 (ED90) 是0.150μg/kg.
- 0.15μg/kg组显示严重的脊柱低血压和恶心/吐显著降低,而高血压或心不增加.
结论:
- 在剖腹产期间,0.05μg/kg/min输注的0.150μg/kg的初始诺亚上腺素玻尿酸是预防脊柱低血压的最佳方法.
- 这一剂量可以降低严重的低血压和恶心/吐,而不会对母亲的心血管产生不良影响.
- 胎儿结局在所有组中都保持了可比性.
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