[1]黄伟,徐莉,谢琳丽,等.不同剂量去氧肾上腺素对剖宫产术中大剂量 布比卡因腰麻后低血压的预防作用[J].中国计划生育和妇产科,2016,(6):31- 34,45.
　HUANG Wei,XU Li,XIE Lin-li,et al.The effects of different doses of phenylephrine on hypotension during high-dose bupivacainespinal anesthesia for cesarean section[J].Chinese Journal of Family Planning & Gynecotokology,2016,(6):31- 34,45.
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不同剂量去氧肾上腺素对剖宫产术中大剂量 布比卡因腰麻后低血压的预防作用
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《中国计划生育和妇产科》[ISSN:1674-4020/CN:51-1708/R]

卷:
期数:
2016年6期
页码:
31- 34,45
栏目:
论著与临床
出版日期:
2016-06-25

文章信息/Info

Title:
The effects of different doses of phenylephrine on hypotension during high-dose bupivacainespinal anesthesia for cesarean section
作者:
黄伟1; 徐莉2; 谢琳丽3; 李平1; 罗林丽1*
1. 610023四川成都，四川大学华西第二医院麻醉科,出生缺陷与相关妇儿疾病教育部重点实验室；2. 610099四川成都，成都市妇女儿童中心医院麻醉科；3.610041 四川 成都，四川大学华西医院西藏成办分院麻醉科
Author(s):
HUANG Wei1; XU Li2; XIE Lin-li3; LI Ping1; LUO Lin-li1*
1．Department of Anesthesiology, West China Second Hospital affiliated of Sichuan University;Key Laboratory of Obstetric Gynecologic and Pediatric Diseases and Birth Defects, Ministry of Education, Chengdu Sichuan, 610041, P.R.China;2．Department of Anesthesiology,Chengdu Women and Children Central Hospital,Chengdu Sichuan 610099, P.R.China;3．Department of Anesthesiology,Hospital of Tibet Autonomous Region to Chengdu Branch of West China Hospital,Chengdu Sichuan 610041, P.R.China
关键词:
去氧肾上腺素; 低血压; 布比卡因; 腰麻; 剖宫产
Keywords:
phenylephrine; hypotension;  bupivacaine; spinal anesthesia; cesarean section
分类号:
R 614.4+1，R 451，R 452
摘要:
目的探讨预注不同剂量去氧肾上腺素对剖宫产术中大剂量布比卡因腰麻后低血压的预防作用。方法将2015年4月至2016年2月在四川大学华西第二医院和成都市妇女儿童医学中心100例拟行择期剖宫产产妇用随机数字表法分为4组，每组各25例。行布比卡因腰麻后立即经莫菲氏管给予去氧肾上腺素50ug（P50组）、100ug（P100组）、150ug（P150组）和5mL生理盐水（C组）。每分钟测量并记录一次收缩压（systolic blood pressure,SBP）和心率（heart rate,HR）。观察低血压、心动过缓、高血压、恶心、呕吐的发生情况和新生儿1min、5min的Apgar评分及脐动脉血气分析结果。结果4组低血压的发生率分别为84 %（C组）、72 %（P50组）、40 %（P100组）和32 %（P150组），组间比较差异有统计学意义（P＜005）。高血压的发生率随去氧肾上腺素剂量增加而增加，P150组最高达到36 %，组间比较差异有统计学意义（P＜005）。心动过缓、恶心的发生率和新生儿1min、5min Apgar评分、新生儿脐动脉血气结果差异无统计学意义（P>005）。结论对剖宫产产妇实施大剂量布比卡因腰麻后，预防性单次注射100ug去氧肾上腺素可以有效降低低血压的发生率。
Abstract:
ObjectiveTo evaluate the effects of prophylactic different doses of phenylephrine during high-dose bupivacaine spinal anesthesia for cesarean section. Methods100 parturients scheduled for cesarean section hospitalized in West China Second Hospital affiliated of Sichuan University and Chengdu Women and Children Central Hospital from April 2015 to February 2016 were randomized to receive 0.9 % saline 5 mL (Control Group) or phenylephrine 50ug (P50 Group), 100ug (P 100 Group), or 150ug (P150 Group) via murphy’s dropper immediately after induction of combined spinalepidural anesthesia. Maternal blood pressure and heart rate were recorded at 1-min intervals until delivery.The incidence of hypotension,hypertension,bradycardia, nausea, and vomiting as well as Apgar scores and umbilical artery blood gases were recorded. ResultsThe incidence of hypotension was 84 % in the Control Group, 72 % in the Group P50, 40 % in the Group P100 and 32 % in the Group P150(P＜0.05). The incidence of hypertension increased as the dose of prophylactic phenylephrine increased (P＜0.05) and was highest in the P150 group (37 %). The incidence of bradycardia, nausea, and vomiting as well as Apgar scores and umbilical artery blood gases did not differ among the four groups(P>0.05). ConclusionsProphylactic injection of phenylephrine 100ug was a suitable alternative method for reducing the incidence of hypotension during high-dose spinal anesthesia for cesarean section.

参考文献/References:

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备注/Memo

备注/Memo:
成都市科技局（项目编号:2014-HM01-00051-SF）
更新日期/Last Update: 1900-01-01