Hollmén A I, Jouppila R, Albright G A, Jouppila P, Vierola H, Koivula A
Acta Anaesthesiol Scand. 1984 Aug;28(4):396-400. doi: 10.1111/j.1399-6576.1984.tb02085.x.
We administered a 15 mg i.v. bolus of ephedrine at the commencement of epidural blockade to nine healthy parturients scheduled for elective caesarean section. Nine other patients did not receive prophylactic ephedrine before epidural anaesthesia (control group). Lactated Ringer solution, 30 ml/kg, was infused before and during blockade, and left uterine displacement was used to minimize aortocaval compression. A133Xe i.v. technique was used to measure intervillous blood flow (IBF) before and 20-25 min after epidural block. The mean arterial pressure (MAP) decreased after epidural blockade in the ephedrine group by 0.67 +/- 0.8 (mean +/- s.d.) kPa and by 1.20 +/- 1.1 (mean +/- s.d.) kPa in the control group. In spite of the decrease in MAP, IBF increased by 6% in patients receiving ephedrine (N.S.), whereas it decreased by 11% in the control group (N.S.). In the ephedrine group there was in this preliminary study a trend to increasing IBF during falling perfusion pressure (MAP). The results of this preliminary study suggest that ephedrine will not affect IBF, but to prevent maternal hypotension ephedrine should be used as an i.v. infusion instead of a bolus injection.
我们对9例计划行择期剖宫产的健康产妇，在硬膜外阻滞开始时静脉推注15mg麻黄碱。另外9例患者在硬膜外麻醉前未接受预防性麻黄碱治疗（对照组）。在阻滞前和阻滞期间输注乳酸林格液，30ml/kg，并采用子宫左倾位以尽量减少主动脉腔静脉受压。采用静脉注射133Xe技术在硬膜外阻滞前和阻滞20 - 25分钟后测量绒毛间隙血流（IBF）。麻黄碱组硬膜外阻滞后平均动脉压（MAP）下降0.67±0.8（均值±标准差）kPa，对照组下降1.20±1.1（均值±标准差）kPa。尽管MAP下降，但接受麻黄碱治疗的患者IBF增加了6%（无统计学意义），而对照组IBF下降了11%（无统计学意义）。在这项初步研究中，麻黄碱组在灌注压（MAP）下降期间有IBF增加的趋势。这项初步研究的结果表明，麻黄碱不会影响IBF，但为预防产妇低血压，麻黄碱应以静脉输注而非静脉推注的方式使用。
