产妇意外硬膜穿破后硬膜外血贴相关的短暂性心动过缓。

Transient bradycardia associated with extradural blood patch after inadvertent dural puncture in parturients.

作者信息

Andrews P J, Ackerman W E, Juneja M, Cases-Cristobal V, Rigor B M

机构信息

Department of Anesthesiology, University of Louisville, School of Medicine, Kentucky.

出版信息

Br J Anaesth. 1992 Oct;69(4):401-3. doi: 10.1093/bja/69.4.401.

DOI:10.1093/bja/69.4.401

PMID:1419451

Abstract

We have studied prospectively 10 ASA I or II postpartum patients after inadvertent dural puncture during labour. An extradural blood patch (autologous blood 15 ml) was performed within 18 h of delivery, with continuous EEG, upper facial EMG (Datex: Anesthesia and Brain Activity Monitor), pulse oximetry and heart rate measurement before, during and for 30 min after extradural injection. Non-invasive arterial pressure measurements (Dinamap) were recorded at 5-min intervals. After extradural blood patch, a statistically significant (Student's t test, P < 0.05) decrease in heart rate, from a mean baseline of 88.6 (SD 7.31) beat min-1 to 51.3 (7.6) beat min-1, occurred within 122.6 (16.9) s from the time of the EBP. Bradycardia was observed for a mean duration of 12.4 (1.1) s. Upper facial EMG, EEG, SpO2 and arterial pressure did not change.

摘要

我们对10例分娩期间意外硬膜穿破的ASA I或II级产后患者进行了前瞻性研究。在分娩后18小时内进行硬膜外血贴（自体血15毫升），在硬膜外注射前、注射期间及注射后30分钟持续进行脑电图、面部上部肌电图（Datex：麻醉与脑活动监测仪）、脉搏血氧饱和度和心率测量。每隔5分钟记录无创动脉压测量值（Dinamap）。硬膜外血贴后，心率从平均基线88.6（标准差7.31）次/分钟降至51.3（7.6）次/分钟，有统计学意义（学生t检验，P<0.05），在硬膜外血贴后122.6（16.9）秒内出现。心动过缓平均持续时间为12.4（1.1）秒。面部上部肌电图、脑电图、SpO2和动脉压未发生变化。