Department of Obstetrics and Gynecology, Faculty of Medicine, Mie University, Tsu 514-8507, Mie, Japan.
Department of Clinical Anesthesiology, Faculty of Medicine, Mie University, Tsu 514-8507, Mie, Japan.
Medicina (Kaunas). 2022 Mar 8;58(3):403. doi: 10.3390/medicina58030403.
: Vasopressors are used for treating maternal hypotension. However, the appropriate administration method and effects on newborns have not been reported. We evaluated maternal blood pressure fluctuation and neonatal findings in patients who received continuous vasopressor administration during elective cesarean sections and those who received bolus vasopressor administration upon onset of hypotension. : We retrospectively analyzed the data of 220 patients scheduled for elective cesarean delivery under spinal anesthesia at Mie University Hospital between April 2017 and March 2021. The patients were classified according to the method of vasopressor administration. Maternal information, intraoperative maternal blood pressure fluctuation, and neonatal findings were examined. A multiple regression analysis was performed for the administration of postpartum neonatal respiratory support using maternal background information and other variables related to blood pressure changes as independent variables. : The Continuous group and the Bolus group were composed of 98 and 122 patients, respectively. No difference was observed in maternal background information between the groups. Significant changes were noted in several blood pressure parameters between both groups. As for neonatal parameters, newborns of Bolus group patients had lower pO, 1 min and 5 min Apgar scores, and required more respiratory support than those of Continuous group patients. In the multiple regression analysis, the groups and maternal post-anesthesia diastolic blood pressure variability were considered explanatory variables. : Maternal hypotension and the need for neonatal respiratory support associated with anesthesia administration in elective cesarean section may be improved by continuous vasopressor administration upon induction of combined spinal-epidural anesthesia.
血管加压素用于治疗产妇低血压。然而，其给药方法和对新生儿的影响尚未见报道。我们评估了在择期剖宫产中接受连续血管加压素给药的患者和在低血压发作时接受血管加压素推注的患者的产妇血压波动和新生儿发现。
我们回顾性分析了 2017 年 4 月至 2021 年 3 月期间在 Mie 大学医院接受脊髓麻醉择期剖宫产的 220 例患者的数据。根据血管加压素给药方法对患者进行分类。检查产妇信息、术中产妇血压波动和新生儿发现。使用产妇背景信息和与血压变化相关的其他变量作为自变量，对产后新生儿呼吸支持的给药进行多元回归分析。
连续组和推注组分别由 98 例和 122 例患者组成。两组产妇的背景信息无差异。两组间几个血压参数均有显著变化。就新生儿参数而言，推注组新生儿的 pO、1 分钟和 5 分钟 Apgar 评分较低，需要更多的呼吸支持。在多元回归分析中，组和产妇麻醉后舒张压变异性被认为是解释变量。
在联合脊髓-硬膜外麻醉诱导时进行连续血管加压素给药，可能会改善择期剖宫产中与麻醉管理相关的产妇低血压和新生儿呼吸支持的需要。
