Ando Yumi, Fukushima Yuji, Shindo Yuki, Takabayashi Reina, Morita Saori, Sin Mifa, Nagano Kazuko, Tateda Takeshi
Department of Anesthesiology, St. Marianna University School of Medicine, Kawasaki 216-8511.
Masui. 2012 Aug;61(8):875-9.
Spinal anesthesia was performed in 40 patients undergoing cesarean section. When systolic blood pressure dropped below 100 mmHg, phenylephrine 100-200 microg (P group) or ephedrine 5-10 mg (E group) was administered. The pH of the umbilical arterial blood was collected after delivery of the baby. Apgar scores, and maternal systolic blood pressure and heart rate before and after each drug administration were compared retrospectively. The umbilical arterial pH and Apgar scores tended to be slightly higher in the P group, but there was no significant difference between the two groups. The rate of blood pressure elevation was 27% in the P group and 41% in the E group. The heart rate decreased significantly in the P group. There was no significant difference in the systolic blood pressure before administration of each drug. Recently, it is reported that the umbilical arterial pH is higher in cases in which phenylephrine is used for hypotension after spinal anesthesia during a cesarean section. However, the optimal dose of phenylephrine is debatable and has not been established. More studies are necessary to determine which drugs should be selected according to the maternal condition.
对40例行剖宫产的患者实施了脊髓麻醉。当收缩压降至100 mmHg以下时，给予去氧肾上腺素100 - 200微克（P组）或麻黄碱5 - 10毫克（E组）。在婴儿娩出后采集脐动脉血的pH值。回顾性比较了阿氏评分以及每次给药前后产妇的收缩压和心率。P组的脐动脉pH值和阿氏评分往往略高，但两组之间无显著差异。P组血压升高率为27%，E组为41%。P组心率显著下降。每种药物给药前的收缩压无显著差异。最近有报道称，剖宫产脊髓麻醉后使用去氧肾上腺素治疗低血压的病例中，脐动脉pH值较高。然而，去氧肾上腺素的最佳剂量存在争议且尚未确定。需要更多研究来确定应根据产妇情况选择哪种药物。
