Department of Women's and Children's Health Uppsala University, Uppsala, Sweden.
BJOG. 2010 Jan;117(1):76-83. doi: 10.1111/j.1471-0528.2009.02356.x.
To investigate whether there is a difference in occurrence of electrocardiogram changes suggestive of myocardial ischaemia between two different doses of oxytocin.
Double-blind randomised controlled trial.
University hospital in Sweden.
A total of 103 healthy women undergoing elective caesarean section under spinal anaesthesia.
The participants were randomised to 5 or 10 units of oxytocin, given as an intravenous bolus. A Holter monitor was used to record electrocardiograms and non invasive blood pressure and heart rate (HR) was monitored. A blood sample was obtained 12-hour postoperatively.
Depression of the ST segment.
symptoms, Troponon I levels, mean arterial pressure (MAP), HR and blood loss.
There was a significant difference in occurrence of ST depressions associated with oxytocin administration, 4 (7.7%) with 5 and 11 (21.6%) with 10 units, P < 0.05. The absolute risk reduction was 13.9% (95% confidence interval, 0.5-27.3). Decrease of mean MAP from baseline to 2 minutes differed, being 9 mmHg in the 5 unit group and 17 mmHg in the 10 unit group (P < 0.01). The increase in mean HR did not differ. Troponin I levels were increased in four subjects (3.9%). There were no differences in occurrence of symptoms, Troponin I levels, or estimated blood loss.
ST depressions were associated with oxytocin administration significantly more often in subjects receiving 10 units compared with 5 units. Interventions to prevent hypotension during caesarean section may reduce the occurrence of ST depressions on electrocardiograms.
探讨两种不同剂量缩宫素引起心电图改变提示心肌缺血的发生率是否存在差异。
双盲随机对照试验。
瑞典一所大学医院。
共 103 例择期行脊髓麻醉剖宫产的健康女性。
将参与者随机分为 5 或 10 单位缩宫素，静脉推注。使用动态心电图监测心电图和无创血压及心率（HR）。术后 12 小时取血样。
ST 段压低。
症状、肌钙蛋白 I 水平、平均动脉压（MAP）、HR 和出血量。
与缩宫素给药相关的 ST 段压低发生率存在显著差异，5 单位组有 4 例（7.7%），10 单位组有 11 例（21.6%），P<0.05。绝对风险降低 13.9%（95%置信区间，0.5%-27.3%）。与基线相比，2 分钟时平均 MAP 的下降在 5 单位组为 9mmHg，在 10 单位组为 17mmHg（P<0.01）。平均 HR 增加无差异。4 例（3.9%）肌钙蛋白 I 水平升高。症状、肌钙蛋白 I 水平或估计出血量无差异。
与 5 单位组相比，接受 10 单位缩宫素的受试者心电图 ST 段压低的发生率显著更高。在剖宫产期间预防低血压的干预措施可能会减少心电图 ST 段压低的发生。
