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剖宫产蛛网膜下腔阻滞术后预防性使用两种不同静脉推注剂量去氧肾上腺素预防低血压的比较研究。

A Comparative Study of Two Different Intravenous Bolus Doses of Phenylephrine Used Prophylactically for Preventing Hypotension after Subarachnoid Block in Cesarean Sections.

作者信息

Prajwal Patel H S, Shashank M R, Shivaramu B T

机构信息

Department of Anaesthesia, Adichunchanagiri Institute of Medical Sciences, Mandya, Karnataka, India.

出版信息

Anesth Essays Res. 2018 Apr-Jun;12(2):381-385. doi: 10.4103/aer.AER_228_17.

Abstract

BACKGROUND AND AIMS

Hypotension occurs in most of the cases following subarachnoid block in for cesarean sections. Studies comparing different bolus doses of phenylephrine for preventing hypotension induced by subarachnoid block in cesarean sections are sparse.

SETTINGS AND DESIGN

This study was conducted to compare the efficacy of two different bolus doses of phenylephrine for preventing subarachnoid block-induced hypotension in cesarean sections.

MATERIALS AND METHODS

Sixty parturients undergoing cesarean section were allocated into two groups. Group A ( = 30) received 150 mcg phenylephrine intravenously (IV) and Group B ( = 30) received 200 mcg phenylephrine IV prophylactically immediately after subarachnoid block. Then, for every 2 min, systolic blood pressure, diastolic blood pressure, mean arterial pressure (MAP), and heart rate (HR) were measured for 20 min, and APGAR scores were measured.

STATISTICAL ANALYSIS

The observations are expressed as mean ± standard deviation and were compared using unpaired -test. The statistical significance of difference between groups was based on value. < 0.05 was considered statistically significant.

RESULTS

There was no difference in preventing hypotension in both the groups, the incidence in Group A being 16.6% and Group B also 16.6%. However, the rise in systolic pressure in Group B was higher than Group A in the first 2-6 min. The incidence of bradycardia was higher in Group B (43.3%) than Group A (20%).

CONCLUSIONS

Both the doses of phenylephrine were equally efficient in prevention of hypotension after subarachnoid block. Lower prophylactic bolus phenylephrine 150 mcg IV is better in the prevention of hypotension after subarachnoid block in cesarean sections as the incidence of bradycardia is higher with phenylephrine 200 mcg.

摘要

背景与目的

剖宫产蛛网膜下腔阻滞术后多数病例会出现低血压。比较不同推注剂量去氧肾上腺素预防剖宫产蛛网膜下腔阻滞所致低血压的研究较少。

设置与设计

本研究旨在比较两种不同推注剂量的去氧肾上腺素预防剖宫产蛛网膜下腔阻滞所致低血压的疗效。

材料与方法

60例接受剖宫产的产妇被分为两组。A组(n = 30)静脉注射150微克去氧肾上腺素,B组(n = 30)在蛛网膜下腔阻滞后立即预防性静脉注射200微克去氧肾上腺素。然后,每隔2分钟测量收缩压、舒张压、平均动脉压(MAP)和心率(HR),共测量20分钟,并测量阿氏评分。

统计分析

观察结果以均值±标准差表示,采用成组t检验进行比较。组间差异的统计学显著性基于P值。P < 0.05被认为具有统计学显著性。

结果

两组在预防低血压方面无差异,A组发生率为16.6%,B组也为16.6%。然而,在最初的2 - 6分钟内,B组收缩压的升高高于A组。B组心动过缓的发生率(43.3%)高于A组(20%)。

结论

两种剂量的去氧肾上腺素在预防蛛网膜下腔阻滞后低血压方面同样有效。在剖宫产蛛网膜下腔阻滞后预防低血压时,静脉注射150微克较低剂量的预防性推注去氧肾上腺素更好,因为200微克去氧肾上腺素导致心动过缓的发生率更高。

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