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剖宫产术中脊髓麻醉时 Tp-e 和 QTc 间期的改变。

Modification of Tp-e and QTc intervals during caesarean section under spinal anaesthesia.

机构信息

Université François-Rabelais de Tours, CHRU Tours, France.

出版信息

Anaesthesia. 2010 Apr;65(4):337-42. doi: 10.1111/j.1365-2044.2010.06246.x. Epub 2010 Feb 10.

Abstract

There are no guidelines for the anaesthetic management of caesarean section in women with long QT syndrome; the description of myocardial ventricular repolarisation in healthy women during caesarean delivery could be a first step. The aim of this study was to describe modification of the QT interval, corrected for heart rate, and the interval between the peak and the end of the T-wave (Tpeak-Tend interval) during caesarean section under spinal anaesthesia. We studied 40 patients scheduled for caesarean section under spinal anaesthesia. Patients were randomly assigned to receive either ephedrine or phenylephrine to prevent hypotension. We injected 5 IU oxytocin after delivery. Corrected QT and Tpeak-Tend intervals were unchanged from pre-operative values after induction of spinal anaesthesia, but increased significantly after oxytocin injection. The choice of vasopressor did not affect the Tpeak-Tend interval. The risk-benefit balance of oxytocin bolus during caesarean delivery should be discussed with women with a history of long QT syndrome.

摘要

目前尚无关于长 QT 综合征女性剖宫产麻醉管理的指南;描述健康女性剖宫产期间心肌心室复极情况可能是第一步。本研究旨在描述脊髓麻醉下剖宫产期间 QT 间期校正心率(QTc)和 T 波峰末间期(Tpeak-Tend 间期)的变化。我们研究了 40 例行脊髓麻醉剖宫产的患者。患者随机分为接受麻黄碱或去氧肾上腺素预防低血压的两组。分娩后我们注射 5IU 催产素。脊髓麻醉诱导后,校正 QTc 和 Tpeak-Tend 间期与术前值相比无变化,但催产素注射后显著增加。血管加压药的选择不影响 Tpeak-Tend 间期。对于长 QT 综合征病史的女性,应讨论在剖宫产期间给予催产素冲击的风险效益平衡。

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