Department of Anesthesia, Women's Hospital, Zhejiang University School of Medicine, Xueshi Road 1, Hangzhou, 310006, China.
Department of Anesthesiology and Perioperative Medicine, Tufts Medical Center, Boston, MA, USA.
BMC Pregnancy Childbirth. 2019 Dec 31;20(1):6. doi: 10.1186/s12884-019-2692-x.
The 90% effective dose (ED) of oxytocin infusion has been previously estimated to be 16.2 IU h. However, bolus administration of oxytocin prior to the infusion may decrease the infusion dose required. The aim of this study was to estimate the ED for oxytocin infusion after a bolus at elective caesarean delivery (CD) in nonlaboring parturients.
We performed a randomized, triple blinded study in 150 healthy termparturients scheduled for elective CD under epidural anaesthesia. After delivery of the infant and i.v. administration of 1 IU oxytocin as a bolus, Participants were randomized to receive oxytocin infusion at a rate of 0, 1, 2, 3, 5, or 8 IU h, to be given for a total of 1 h. Uterine tone assessed by the blinded obstetrician as either adequate or inadequate. Secondary outcomes included estimated blood loss (EBL), requirement for supplemental uterotonic agents, and development of side effects.
The 95% effective dose (ED) of oxytocin infusion was estimated to be 7.72 IU h (95% confidence interval 5.80-12.67 IU h). With increasing oxytocin infusion rate, the proportion of parturients who needed rescue oxytocin bolus or secondary uterotonic agents decreased. No significant among-group differences in the EBL and oxytocin-related side effects were observed.
In parturients who receive a 1 IU bolus of oxytocin during elective cesarean delivery, an infusion rate of oxytocin at 7.72 IU h will produce adequate uterine tone in 95% of parturients. These results suggest that the total dose of oxytocin administered in the postpartum period can be decreased when administered as an infusion after oxytocin bolus.
先前估计缩宫素输注的 90%有效剂量（ED）为 16.2IU·h。然而，在输注前给予缩宫素推注可能会减少所需的输注剂量。本研究旨在估计在硬膜外麻醉下择期剖宫产时，产妇未临产时给予缩宫素推注后输注的 ED。
我们在 150 例健康足月产妇中进行了一项随机、三盲研究，这些产妇在硬膜外麻醉下择期行剖宫产。胎儿娩出后，静脉给予 1IU 缩宫素推注，然后将产妇随机分为 0、1、2、3、5 或 8IU·h 的输注速率，输注 1 小时。由盲法产科医生评估子宫收缩情况，判断是否足够。次要结局包括估计失血量（EBL）、需要补充宫缩剂以及发生副作用的情况。
缩宫素输注的 95%有效剂量（ED）估计为 7.72IU·h（95%置信区间 5.80-12.67IU·h）。随着缩宫素输注率的增加，需要救援性缩宫素推注或辅助宫缩剂的产妇比例降低。未观察到 EBL 和与缩宫素相关的副作用在各组之间有显著差异。
在择期剖宫产时接受 1IU 缩宫素推注的产妇中，输注 7.72IU·h 的缩宫素将使 95%的产妇产生足够的子宫收缩。这些结果表明，当在缩宫素推注后给予输注时，产后给予的缩宫素总剂量可以减少。
