Sarna M C, Soni A K, Gomez M, Oriol N E
Department of Anesthesia & Critical Care, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts 02215, USA.
Anesth Analg. 1997 Apr;84(4):753-6. doi: 10.1097/00000539-199704000-00010.
The objective of this study was to compare four different doses of oxytocin to determine its minimal effective dose during elective cesarean section. A prospective, double-blind, randomized study was undertaken in 40 healthy term parturients presenting for elective cesarean section under regional anesthesia. Subjects were assigned to one of four groups. Group I received 5 IU, Group II 10 IU, Group III 15 IU, and Group IV 20 IU of oxytocin after clamping of the umbilical cord. Uterine tone was assessed by palpation on a linear analog scale (LAS) of 0 to 10 (0 = completely atonic, 10 = fully contracted) at 5, 10, 15 and 20 min after the start of oxytocin infusion. Estimated blood loss (EBL) and the difference in pre- and postoperative hematocrit (delta Hct) were also recorded. At alpha = 0.05, the study design had a power of 95% to detect a 25% difference in the LAS between the four groups. There were no differences in the uterine tone in the four groups at any of the four intervals. EBL and delta Hct were similar in all four groups. There appears to be no benefit in terms of degree of uterine contraction and amount of blood loss to administering more than 5 IU of intravenous oxytocin to term parturients undergoing elective cesarean section with a neuraxial block.
本研究的目的是比较四种不同剂量的缩宫素，以确定其在择期剖宫产术中的最小有效剂量。对40例在区域麻醉下进行择期剖宫产的健康足月产妇进行了一项前瞻性、双盲、随机研究。将受试者分为四组。脐带钳夹后，第一组接受5 IU缩宫素，第二组接受10 IU，第三组接受15 IU，第四组接受20 IU。在缩宫素输注开始后5、10、15和20分钟，通过线性模拟量表（LAS）（0至10，0 = 完全无张力，10 = 完全收缩）触诊评估子宫张力。还记录了估计失血量（EBL）和术前及术后血细胞比容差值（δHct）。在α = 0.05时，该研究设计有95%的检验效能来检测四组之间LAS的25%差异。在四个时间间隔中的任何一个，四组的子宫张力均无差异。所有四组的EBL和δHct相似。对于接受神经轴阻滞的择期剖宫产足月产妇，静脉注射超过5 IU缩宫素，在子宫收缩程度和失血量方面似乎并无益处。
