Department of Anesthesiology, Academic Hospital of University of São Paulo, São Paulo, Brazil.
Int J Obstet Anesth. 2011 Jul;20(3):224-8. doi: 10.1016/j.ijoa.2011.03.004.
The aim of this study was to determine serum oxytocin concentrations following different regimens of prophylactic oxytocin administration in women undergoing elective caesarean delivery.
Thirty healthy pregnant patients were randomized, after clamping of the umbilical cord, to receive intravenous oxytocin in one of the following groups: G1 (n=9), 10 IU of oxytocin infused over 30 min (0.33 IU/min); G2 (n=11), 10 IU of oxytocin infused over 3 min and 45 s (2.67 IU/min); and G3 (n=10), 80 IU of oxytocin infused over 30 min (2.67 IU/min). Both patient and surgeon were blinded to allocation. Uterine tone was assessed by surgical palpation. Serum oxytocin concentration was determined by enzyme immunoassay before anaesthesia (T0) and at 5 (T5), 30 (T30) and 60 (T60) min after the start of oxytocin infusion.
Serum oxytocin concentrations (mean±standard error, ng/mL) were not significantly different in the groups at T0 (0.06±0.02, 0.04±0.02 and 0.07±0.04, respectively, P=0.76), and T60 (0.65±0.26, 0.36±0.26 and 0.69±0.26, respectively, P=0.58). G3 showed higher concentrations than G1 at T5 (3.65±0.74 versus 0.71±0.27, P=0.01) and at T30 (6.19±1.19 versus 1.17±0.37, P<0.01), and were higher than G2 at T30 (6.19±1.19 versus 0.41±0.2, P<0.01). Haemodynamic data and uterine tone were considered satisfactory and similar in all groups. No additional uterotonic agents were needed.
Serum oxytocin measurements made using enzyme immunoassay in healthy pregnant women undergoing elective caesarean delivery showed that administration of 80 IU oxytocin over 30 min resulted in higher serum oxytocin levels after 5 and 30 min than the two other regimens. The concentrations did not differ between groups at 60 min.
本研究旨在确定行择期剖宫产术的妇女在接受不同方案的预防性催产素给药后血清催产素浓度。
30 例健康孕妇随机分为三组，在脐带夹闭后静脉给予催产素：G1 组（n=9），催产素 10IU 输注 30 分钟（0.33IU/min）；G2 组（n=11），催产素 10IU 输注 3 分 45 秒（2.67IU/min）；G3 组（n=10），催产素 80IU 输注 30 分钟（2.67IU/min）。患者和外科医生均对分组情况不知情。通过手术触诊评估子宫张力。在麻醉前（T0）及催产素输注开始后 5（T5）、30（T30）和 60（T60）分钟时，通过酶免疫测定法测定血清催产素浓度。
T0 时，各组间血清催产素浓度（均值±标准误差，ng/mL）无显著差异（分别为 0.06±0.02、0.04±0.02 和 0.07±0.04，P=0.76），T60 时亦无显著差异（分别为 0.65±0.26、0.36±0.26 和 0.69±0.26，P=0.58）。T5 时，G3 组的浓度明显高于 G1 组（3.65±0.74 与 0.71±0.27，P=0.01）和 G2 组（3.65±0.74 与 0.41±0.20，P<0.01），T30 时，G3 组的浓度明显高于 G1 组（6.19±1.19 与 1.17±0.37，P<0.01）和 G2 组（6.19±1.19 与 0.41±0.20，P<0.01）。所有组的血流动力学数据和子宫张力均被认为是令人满意且相似的。不需要额外使用子宫收缩剂。
在接受择期剖宫产术的健康孕妇中，使用酶免疫分析法测定血清催产素水平显示，与另外两种方案相比，30 分钟内输注 80IU 催产素可导致 5 分钟和 30 分钟后的血清催产素水平更高。60 分钟时，各组间浓度无差异。
