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剖宫产术后卡贝缩宫素与缩宫素的比较:疗效相似,但产后出血高危女性的疼痛感知减轻。

Carbetocin versus oxytocin after caesarean section: similar efficacy but reduced pain perception in women with high risk of postpartum haemorrhage.

作者信息

De Bonis Maria, Torricelli Michela, Leoni Licia, Berti Paolo, Ciani Valentina, Puzzutiello Rosa, Severi Filiberto Maria, Petraglia Felice

机构信息

Section of Obstetrics and Gynecology, Department of Pediatrics, Obstetrics, and Reproductive Medicine, University of Siena, Siena, Italy.

出版信息

J Matern Fetal Neonatal Med. 2012 Jun;25(6):732-5. doi: 10.3109/14767058.2011.587920. Epub 2011 Jul 15.

Abstract

OBJECTIVE

To compare the effectiveness of carbetocin with oxytocin with respect to maintain adequate uterine tone and to reduce the incidence and severity of postpartum haemorrhage. Moreover safety, adverse effects and the need of additional medications were evaluated.

METHODS

Prospective controlled clinical trial. We compared the effect of a single dose of carbetocin (n = 55) with oxytocin infusion (n = 55) in a women population undergoing to elective caesarean section with regional subarachnoid anaesthesia with at least one risk factor for postpartum haemorrhage.

RESULTS

The mean ± SD of postoperative pain in the day of surgery in carbetocin group was significantly lower than in oxytocin group and remained significant till the third day after caesarean section. In the day of surgery and the first day after surgery, women of carbetocin group who needed analgesic drugs were significantly lower than women of oxytocin group. The differences of diuresis and of diuretic drugs need were not statistically significant between the two groups.

CONCLUSIONS

A single carbetocin injection is efficacious and safe on the maintenance of uterine tone and on the limitation of blood losses, in peri- and in postoperative period. In addition, carbetocin was able to reduce pain perception during postoperative days improving quality life of women.

摘要

目的

比较卡贝缩宫素与缩宫素在维持子宫适度收缩及降低产后出血发生率和严重程度方面的有效性。此外,还评估了安全性、不良反应及额外用药需求。

方法

前瞻性对照临床试验。我们比较了单剂量卡贝缩宫素(n = 55)与缩宫素静脉滴注(n = 55)对接受择期剖宫产且采用蛛网膜下腔麻醉并有至少一项产后出血危险因素的女性人群的影响。

结果

卡贝缩宫素组术后当日的平均疼痛程度(均值±标准差)显著低于缩宫素组,且直至剖宫产术后第三天仍有显著差异。在手术当日及术后第一天,需要使用镇痛药的卡贝缩宫素组女性显著少于缩宫素组女性。两组间的尿量及利尿药使用需求差异无统计学意义。

结论

单次注射卡贝缩宫素在围手术期及术后维持子宫收缩和限制失血方面有效且安全。此外,卡贝缩宫素能够降低术后疼痛感受,改善女性生活质量。

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