Yildiz K, Dogru K, Dalgic H, Serin I S, Sezer Z, Madenoglu H, Boyaci A
Department of Anesthesiology, Erciyes University School of Medicine, Kayseri, Turkey.
Acta Anaesthesiol Scand. 2005 Oct;49(9):1355-9. doi: 10.1111/j.1399-6576.2005.00804.x.
In this study, we investigated the inhibitory effects of desflurane and sevoflurane on oxytocin-induced contractions of isolated human myometrium.
Following delivery of the infant and placenta, a small segment of myometrium was excised from the upper incisional surface of the lower uterine segment and 20 strips, randomly assigned into two groups (n = 10), were obtained from 20 non-laboring term parturients. The study protocol consisted of a 60-min period of spontaneous contractions, control recording with oxytocin 2 x 10(9) m (10-min period), washout interval of 10 min, volatile administration (three times per 15-min period) of 0.5, 1 and 2 minimum alveolar concentration (MAC), response to oxytocin (10-min period), a further washout interval (10-min period) and subsequent control recording with oxytocin without anesthetics.
After oxytocin administration, the frequency and amplitude of contractions increased (P < 0.05) and the duration decreased (P < 0.05). The frequency and amplitude of contractions induced with oxytocin decreased significantly at 0.5, 1 and 2 MAC of desflurane and sevoflurane (P < 0.05). The amplitude of contractions was significantly different at 1 MAC between the two groups (P < 0.05). The duration of contractions at 2 MAC decreased in both groups (P < 0.05).
Desflurane and sevoflurane at 0.5, 1 and 2 MAC inhibit the frequency and amplitude of myometrial contractions induced with oxytocin in a dose-dependent manner. However, desflurane inhibits the amplitude less than sevoflurane at 1 MAC. We suggest that 0.5 MAC of both agents and 1 MAC of desflurane may be safely used in the presence of oxytocin following delivery of the infant and placenta during Cesarean section without fear of uterine atony and hemorrhage.
在本研究中，我们调查了地氟烷和七氟烷对催产素诱导的离体人子宫肌层收缩的抑制作用。
婴儿和胎盘娩出后，从子宫下段上切口表面切除一小段子宫肌层，从20例非临产足月产妇中获取20条肌条，随机分为两组（n = 10）。研究方案包括60分钟的自发收缩期、用2×10⁻⁹ m催产素进行对照记录（10分钟期）、10分钟的洗脱期、以0.5、1和2最低肺泡浓度（MAC）进行挥发性药物给药（每15分钟给药三次）、对催产素的反应（10分钟期）、进一步的洗脱期（10分钟期）以及随后不用麻醉剂的催产素对照记录。
给予催产素后，收缩的频率和幅度增加（P < 0.05），持续时间缩短（P < 0.05）。地氟烷和七氟烷在0.5、1和2 MAC时，催产素诱导的收缩频率和幅度显著降低（P < 0.05）。两组在1 MAC时收缩幅度有显著差异（P < 0.05）。两组在2 MAC时收缩持续时间均缩短（P < 0.05）。
地氟烷和七氟烷在0.5、1和2 MAC时以剂量依赖方式抑制催产素诱导的子宫肌层收缩的频率和幅度。然而，地氟烷在1 MAC时对幅度的抑制作用小于七氟烷。我们建议，在剖宫产术中婴儿和胎盘娩出后，在有催产素存在的情况下，两种药物的0.5 MAC以及地氟烷的1 MAC可以安全使用，不用担心子宫收缩乏力和出血。
