充气腰枕对脊柱低血压在剖腹产中的作用:一项非盲目的随机对照试验
Peiying Shen1, Li Wan1, Ying Zou1
1Anesthesiology and Perioperative Medicine, Jiaxing Maternity and Children Health Care Hospital, Affiliated Women and Children Hospital of Jiaxing University, Jiaxing, Zhejiang, China.
可充气腰枕 (ILP) 有效地降低了基的需要,并降低了剖腹产期间低血压和恶心的发生率. 这种干预措施有助于在孕妇中治疗脊髓麻醉并发症.
科学领域:
- 产科和妇科
- 麻醉学
- 心血管生理学
背景情况:
- 孕妇的子宫可能会导致卧卧的动脉压,在剖腹产期间可能会导致脊柱低血压的恶化.
- 一个充气的腰枕 (ILP) 被开发来缓解子宫诱导的心腔压缩,通过将子宫抬高在卧底位置.
- 烯通常用于抵消在剖腹产中脊髓麻醉后的低血压.
研究的目的:
- 评估充气腰枕 (ILP) 在剖腹产期间脊椎麻醉后降低血压所需的费尼莱弗林剂量的有效性.
- 评估ILP对低血压和恶心等相关症状的影响.
主要方法:
- 一项随机对照试验,涉及123名健康妇女在脊髓麻醉下进行剖腹产.
- 参与者被分配到ILP组 (n=61) 或对照组 (n=62).
- 在ILP组中,在麻醉后将ILP膨胀至子宫切口时,开始注入基25μg/ min,并进行定位以维持静脉压.
主要成果:
- 与对照组相比,ILP组需要显著较低的基剂量 (27. 9 ± 3. 8μg/ min与36. 7 ± 8. 3μg/ min,P < 0. 001).
- 在ILP组中,低血压的发生率显著降低 (11. 5%对比25. 8%,P=0. 042).
- 在ILP组中,恶心的发病率也显著降低 (4. 9% vs 22. 6%,P = 0. 005),而在其他孕产妇或新生儿结局方面没有显著差异.
结论:
- 充气腰枕 (ILP) 有效地降低了基的剂量以及与剖腹产脊柱麻醉相关的低血压和恶心的发生率.
- 在剖腹产期间,ILP在控制大动脉压缩方面具有潜在的益处.
- 需要进一步的研究,以形态验证ILP对大动脉腔压缩的影响.
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