Department of Anaesthesia, Royal Free London Hospital, London, UK.
Anaesthesia. 2013 Oct;68(10):1021-5. doi: 10.1111/anae.12381. Epub 2013 Aug 15.
Debate continues over the dose and methods of administration of oxytocin for the prevention of haemorrhage during caesarean section. We surveyed 206 lead obstetric anaesthetists in the UK to determine standard practice in their unit as well as any differences in practice for high-risk cases. There were 150 responses (72.9% response rate). A total of 149 units use oxytocin. The majority use an initial 5-IU dose, whilst a small proportion (8; 5.3%) administer a dose < 5 IU for elective caesarean section. The administration of a 10-IU dose has ceased altogether. There is a broad range of administration methods, particularly with infusions. Forty (26.8%) respondents give a different oxytocin regimen following caesarean section in patients with severe pre-eclampsia, 72 (48.3%) in those with cardiac disease of New York Heart Association class 1-2, and 100 (66.7%) with class 3-4. In conclusion, there is a trend towards the use of lower doses of oxytocin in caesarean section, but there are still wide variations in detail. We suggest that there is a need for a national protocol to standardise oxytocin administration.
关于缩宫素用于剖宫产术中出血预防的剂量和给药方法仍存在争议。我们调查了英国的 206 名首席产科麻醉师，以确定其所在单位的标准实践，以及高危病例实践中的任何差异。共收到 150 份回复（72.9%的回复率）。共有 149 个单位使用缩宫素。大多数单位使用初始 5IU 剂量，而少数单位（8 个；5.3%）对选择性剖宫产给予<5IU 的剂量。10IU 剂量的给药已完全停止。给药方法多种多样，特别是输注方法。40 名（26.8%）受访者在患有严重子痫前期的剖宫产患者中使用不同的缩宫素方案，72 名（48.3%）在纽约心脏协会 1-2 级心脏病患者中使用，100 名（66.7%）在 3-4 级心脏病患者中使用。总之，剖宫产术中使用较低剂量缩宫素的趋势明显，但细节仍存在广泛差异。我们建议需要制定国家方案来规范缩宫素的给药。
