[1]李梦倩,孙凯,吴树彪,等.腰硬联合麻醉下剖宫产术中甲氧明的用药时机[J].郑州大学学报(医学版),2016,(01):119-121.
 LI Mengqian,SUN Kai,WU Shubiao,et al.Bolus administration time of methoxamine during caesarean delivery under combined spinalepidural anaesthesia[J].JOURNAL OF ZHENGZHOU UNIVERSITY(MEDICAL SCIENCES),2016,(01):119-121.
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腰硬联合麻醉下剖宫产术中甲氧明的用药时机()
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《郑州大学学报(医学版)》[ISSN:1671-6825/CN:41-1340/R]

卷:
期数:
2016年01期
页码:
119-121
栏目:
应用研究
出版日期:
2016-01-20

文章信息/Info

Title:
Bolus administration time of methoxamine during caesarean delivery under combined spinalepidural anaesthesia
作者:
李梦倩孙凯吴树彪董铁立#
郑州大学第二附属医院麻醉科 郑州450014
Author(s):
LI MengqianSUN KaiWU ShubiaoDONG Tieli
Department of Anesthesiology,the Second Affiliated Hospital,Zhengzhou University, Zhengzhou 450014
关键词:
腰硬联合麻醉剖宫产甲氧明
Keywords:
combined spinalepidural anaesthesiacaesareanmethoxamine
分类号:
R719.8
文献标志码:
A
摘要:
目的:探讨剖宫产手术中甲氧明防治低血压的最佳用药时机。方法:择期行子宫下段剖宫产手术产妇90例,分为3组。Ⅰ组在腰麻药注入后即刻静脉注射甲氧明0.02 mg/kg,Ⅱ组在腰麻药注入后1 min时静脉注射甲氧明0.02 mg/kg,Ⅲ组在腰麻药注入后产妇出现血压下降超过基础值10%时静脉注射甲氧明0.02 mg/kg,分别记录腰麻前(T0),腰麻后1(T1)、2(T2)、3(T3)、5(T4)、10(T5)、15(T6) min时的心率、连续无创动脉血压以及新生儿脐动脉血气分析和1 min、5 min Apgar评分,记录3组高血压、低血压及恶心、呕吐等不良反应发生情况。结果:与T0比较,Ⅰ组在T1、T2时血压升高(P<0.05),Ⅲ组在T2时血压下降(P<0.05),Ⅱ组血压无明显被动。3组在用药后心率均明显下降(P<0.05),但逐渐趋于平稳,未出现心动过缓。Ⅰ组、Ⅱ组恶心发生率低于Ⅲ组(P<0.001)。Ⅰ组高血压的发生率高于Ⅱ组和Ⅲ组(P<0.001)。3组新生儿脐动脉血气分析和1 min、5 min Apgar评分差异均无统计学意义(P>0.05)。结论:在腰硬联合麻醉下剖宫产手术中,容量共同负荷及腰麻后1 min是使用甲氧明防治产妇低血压的最佳时机。
Abstract:
Aim: To explore the best time of methoxamine bolus administration for preventing hypotension during caesarean section under spinalepidural anesthesia.Methods: A total of 90 women undergoing selective caesarean section under combined spinalepidural anaesthesia were allocated into 3 groups with 30 in each group. Group Ⅰ:immediate bolus injection of methoxamine at 0.02 mg/kg was adopted after intrathecal injection of local anesthesia. Group Ⅱ:immediate bolus injection of methoxamine at 0.02 mg/kg was adopted at 1 min after intrathecal injection of local anesthesia.Group Ⅲ:immediate bolus injection of methoxamine at 0.02 mg/kg was adopted when continuous noninvasive arterial pressure decreased by 10% over baseline.The change of maternal hemodynamic before anesthesia(T0),1 min(T1), 2 min(T2), 3 min(T3), 5 min(T4), 10 min(T5), 15 min(T6) after spinal anesthesia, umbilical arterial blood gases and infant Apgar score were recorded. The incidence of hypertension, hypotension, nausea and vomiting were also recorded.Results: Compared with T0, the blood pressure rose at T1 and T2 in group Ⅰ and fell at T2 in group Ⅲ. The fall of heart rate was significant in the 3 groups(P<0.05). Compared with group Ⅲ, the incidence of nausea in group Ⅰ and group Ⅱwere lower(P<0.001). Compared with group Ⅱ and group Ⅲ, the incidence of hypertension in group Ⅰ was higher(P<0.001).There was no significant difference in the umbilical artery blood or neonatal Apgar score among the 3 groups(P>0.05).Conclusion: One min after intrathecal injection is the best time of methoxamine bolus administration for preventing hypotension during caesarean section under spinalepidural anesthesia.

参考文献/References:

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更新日期/Last Update: 1900-01-01