James C F, Banner T, Caton D
Department of Anesthesiology, University of Florida College of Medicine, Gainesville.
Am J Obstet Gynecol. 1989 May;160(5 Pt 1):1178-84. doi: 10.1016/0002-9378(89)90184-1.
Cardiac output during cesarean section and for 24 hours after delivery was estimated by using a noninvasive ultrasonic Doppler technique and was compared between term pregnant patients who underwent either epidural or general anesthesia. Cardiac output peaked by 36.7% and 26.3% of baseline values at 15 and 30 minutes after delivery, respectively, with epidural anesthesia and by 28% and 17.2%, respectively, with general anesthesia. From 60 minutes to 24 hours after delivery, cardiac output in both groups remained elevated at preoperative levels. This study demonstrates a similar pattern of increase in cardiac output with epidural and general anesthesia and a return by 60 minutes to preoperative levels, which persisted for up to 24 hours after delivery. The applicability of this noninvasive technique can be extended in various circumstances during pregnancy, labor, delivery, and the postpartum period to further define cardiac output in pregnancy.
采用无创超声多普勒技术估算剖宫产术中及产后24小时的心输出量，并对接受硬膜外麻醉或全身麻醉的足月妊娠患者的心输出量进行比较。硬膜外麻醉下，产后15分钟和30分钟的心输出量分别达到基线值的36.7%和26.3%，全身麻醉下分别为28%和17.2%。产后60分钟至24小时，两组的心输出量均维持在术前水平。本研究表明，硬膜外麻醉和全身麻醉下心输出量的增加模式相似，且术后60分钟可恢复至术前水平，并持续至产后24小时。这种无创技术的适用性可在妊娠、分娩、产后的各种情况下扩展，以进一步明确妊娠期的心输出量。
