在分娩时硬膜外镇痛期间进行液体输注以减少胎儿心率异常和产妇低血压。
Fluid loading to reduce abnormalities of fetal heart rate and maternal hypotension during epidural analgesia in labour.
作者信息
Collins K M, Bevan D R, Beard R W
出版信息
Br Med J. 1978 Nov 25;2(6150):1460-1. doi: 10.1136/bmj.2.6150.1460.
Abstract
Fetal heart rate (FHR) was recorded and maternal blood pressure measured in 104 patients in whom lumbar epidural analgesia was induced in labour. Fifty-one patients received an intravenous load of 11 of Hartmann's solution immediately before the epidural injection. This infusion significantly reduced the incidence of abnormalities of FHR from 34% to 12% and of maternal hypotension from 28% to 2%. We did not study mothers with pre-eclampsia and hypertension, but we conclude that there is a strong case for preloading all other mothers in whom lumbar epidural analgesia is induced in labour.
摘要
对104例分娩时接受腰段硬膜外镇痛的患者记录了胎心率（FHR）并测量了产妇血压。51例患者在硬膜外注射前立即静脉输注1升复方氯化钠溶液。这种输注显著降低了FHR异常的发生率，从34%降至12%，产妇低血压的发生率从28%降至2%。我们没有研究患有先兆子痫和高血压的母亲，但我们得出结论，对于所有其他分娩时接受腰段硬膜外镇痛的母亲，有充分的理由进行预负荷。
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Anesth Analg. 1969 Nov-Dec;48(6):986-94.
3
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