Dennehy K C, Rosaeg O P, Cicutti N J, Krepski B, Sylvain J P
Department of Anaesthesia, Ottawa Hospital, University of Ottawa, Ontario, Canada.
Can J Anaesth. 1998 Jul;45(7):635-9. doi: 10.1007/BF03012092.
To determine, after Caesarean delivery, uterine contractility and blood pressure following intravenous (i.v.) and intramyometrial (imy) injection of oxytocin.
In a double-blind clinical trial 40 parturients scheduled for elective Caesarean section with spinal anaesthesia were randomized into two equal groups. One litre Ringer's lactate was administered i.v. before intrathecal injection of 1.7 ml bupivacaine 0.75% and 0.3 mg morphine. All patients received simultaneous i.v. and imy injections after removal of the placenta. Patients in Group 1 received 5 IU (10 IU.ml-1) oxytocin i.v. and 2 ml saline imy: Group 2 patients received 0.5 ml saline i.v. and 20 IU oxytocin into the myometrium. Baseline systolic blood pressure (SBP) and heart rate were measured before delivery and at one minute intervals for 15 min after injection of study solutions. Uterine contractility was assessed at 1, 2, 4, 6, 8, 10 and 15 min after oxytocin injection. Haemoglobin concentration before surgery and on first post-operative day was also recorded.
Mean decrease in systolic blood pressure (SBP) one minute after oxytocin was 8.4 mmHg in Group vs 14.6 mmHg in Group 2 (P < 0.001). Systolic blood pressure returned to baseline two minutes after oxytocin in Group 1 and after three minutes in Group 2. Uterine contractility and change in haemoglobin concentration were similar in both groups.
Intramyometrial administration of 20 IU oxytocin after Caesarean delivery is associated with more severe hypotension than is i.v. injection of 5 IU oxytocin. Route of oxytocin injection did not affect uterine tone.
确定剖宫产术后静脉注射（i.v.）和肌层内注射（imy）催产素后的子宫收缩力和血压。
在一项双盲临床试验中，将40例计划行择期剖宫产并采用脊麻的产妇随机分为两组，每组20例。在鞘内注射1.7 ml 0.75%布比卡因和0.3 mg吗啡之前静脉输注1升乳酸林格氏液。所有患者在胎盘娩出后同时接受静脉注射和肌层内注射。第1组患者静脉注射5 IU（10 IU/ml）催产素，肌层内注射2 ml生理盐水；第2组患者静脉注射0.5 ml生理盐水，肌层内注射20 IU催产素。在分娩前以及注射研究溶液后，每隔1分钟测量一次基线收缩压（SBP）和心率，共测量15分钟。在注射催产素后1、2、4、6、8、10和15分钟评估子宫收缩力。记录术前和术后第一天的血红蛋白浓度。
注射催产素1分钟后，第1组收缩压平均下降8.4 mmHg，第2组为14.6 mmHg（P < 0.001）。第1组注射催产素2分钟后收缩压恢复至基线水平，第2组为3分钟后。两组的子宫收缩力和血红蛋白浓度变化相似。
剖宫产术后肌层内注射20 IU催产素比静脉注射5 IU催产素导致的低血压更严重。催产素的注射途径不影响子宫张力。
