David M, Sehouli J, Plischek S, Halle H, Lichtenegger W
Virchow-Klinikum, Medizinische Fakultät der Humboldt-Universität zu Berlin.
Z Geburtshilfe Neonatol. 1998 Jul-Aug;202(4):168-71.
Between June 1994 and July 1996, a prospective, randomized, double-blind clinical study was carried out on 97 patients scheduled for elective cesarean section under general anesthesia at the gynecology departments of the Virchow and Charité Hospitals (both university hospitals of the Humboldt University, Berlin) in order to test the efficacy of glycerol nitrate (GTN: syn.: nitroglycerin) as an intraoperative short-acting tocolytic agent to ease fetal extraction in cesarean section in comparison to a placebo. At the time of the uterine puncture incision, either 0.25 mg (n = 32 patients) or 0.5 mg (n = 34) of GTN or physiological saline (n = 31) was administered as an intravenous bolus. Maternal and fetal pulse rates and blood pressures were closely monitored. The authors developed a scale to evaluate the degree of decrease in uterine tone and the ease of fetal extraction. The statistical evaluation of these estimations revealed no significant easing of fetal extraction and no significant increase in the reduction of uterine tone after administration of both GTN dosages in comparison to the administration of placebo (p > 0.01). Easing of fetal extraction cannot be achieved with the administration of 0.25 or 0.5 mg GTN, at least not in elective cesarean sections of greater than 34 weeks of gestation.
1994年6月至1996年7月期间，在柏林洪堡大学的维尔肖医院和夏里特医院（均为大学医院）的妇科，对97例计划在全身麻醉下进行择期剖宫产的患者开展了一项前瞻性、随机、双盲临床研究，以测试硝酸甘油（GTN：同义词：硝酸甘油）作为术中短效宫缩抑制剂，与安慰剂相比在剖宫产中辅助娩出胎儿的疗效。在子宫穿刺切开时，静脉推注0.25 mg（n = 32例患者）或0.5 mg（n = 34例）的GTN或生理盐水（n = 31例）。密切监测母体和胎儿的脉搏率及血压。作者制定了一个量表来评估子宫张力下降程度和胎儿娩出的难易程度。对这些评估结果的统计学分析显示，与给予安慰剂相比，给予两种剂量的GTN后，胎儿娩出未显著更容易，子宫张力降低也未显著增加（p>0.01）。给予0.25或0.5 mg GTN不能实现胎儿娩出更容易，至少在妊娠超过34周的择期剖宫产中不行。
