去氧肾上腺素与间羟胺预防剖宫产术腰硬联合麻醉后低血压等效剂量的比较

发布时间：2018-06-30 10:28

本文选题：腰硬联合麻醉 + 去氧肾上腺素　；参考：《四川大学学报(医学版)》2017年06期

【摘要】：目的研究去氧肾上腺素和间羟胺在预防剖宫产术腰硬联合麻醉后低血压的半数有效剂量(ED50),并计算二者等效比。方法 103例单胎足月孕拟行择期剖宫产术患者分为去氧肾上腺素组(41例)和间羟胺组(62例)。常规行腰硬联合麻醉,麻醉完成后即刻开始泵注试验用药,去氧肾上腺素和间羟胺初始质量浓度分别为1.0mg/100mL和2.0mg/100mL,固定输注速率为100mL/h,试验采用序贯法决定下一病例药物剂量,两种药物剂量梯度为0.05mg。观察术中血压、不良反应及胎儿脐血血气分析结果。以术中观察期间患者收缩压低于基础值80%或90mmHg(1mmHg=0.133kPa),定为该试验剂量无效,患者收缩压≥基础值,则视为该试验剂量有效。采用Probit回归分析测量试验药物的ED50及其95%可信区间(CI)。结果在试验条件下,维持剖宫产术腰硬联合麻醉后血压于基础值水平所需去氧肾上腺素和间羟胺ED50分别为1.221 7mg(95%CI为1.099 1~1.593 7)和2.824 0mg(95%CI为2.658 9~3.433 6),两种药物等效比值为1∶2.3。术中两种药物副作用及两组胎儿脐血血气分析比较差异无统计学意义(P0.05)。结论以100mL/h持续泵注,维持产妇腰硬联合麻醉后血压于基础水平所需的去氧肾上腺素和间羟胺ED50分别为1.221 7mg/100mL和2.824 0mg/100mL,二者等效比值为1∶2.3。
[Abstract]:Objective to study the median effective dose (ED50) of deoxyadrenaline and hydroxylamine in the prevention of caesarean section after combined spinal and epidural anesthesia, and to calculate the equivalent ratio of two cases. Methods 103 cases of single term single term pregnancy were divided into 41 cases (41 cases) and intervertebral hydroxylamine group (62 cases). The initial mass concentration of adrenaline and hydroxylamine was 1.0mg/100mL and 2.0mg/100mL, respectively, the initial mass concentration of adrenaline and hydroxylamine was 1.0mg/100mL and 2.0mg/100mL, and the fixed infusion rate was 100mL/h. The sequential method was used to determine the dosage of the next case. The two drug dose gradient was 0.05mg., the adverse reaction and fetal umbilical blood gas analysis results were observed. When the systolic pressure was lower than the base value of 80% or 90mmHg (1mmHg=0.133kPa) during the intraoperative observation, the test dose was invalid and the systolic pressure of the patient was more than the base value, which was considered to be the effective dose. Probit regression analysis was used to measure the ED50 of the test drug and its 95% confidence interval (CI). Deoxyadrenaline and hydroxylamine ED50 were 1.221 7Mg (95%CI 1.099 1~1.593 7) and 2.824 0mg (95%CI 2.658 9~3.433 6), respectively. The equivalent ratio of two kinds of drugs was 1: 2.3., and two groups of fetal umbilical blood gas analysis were not statistically significant (P0.05). The conclusion was 100. ML/h continued to pump, to maintain the essential level of deoxyadrenaline and interhydroxylamine ED50, 1.221 7mg/100mL and 2.824 0mg/100mL respectively, and the equivalent ratio of 1: 2.3. to the basic level of the parturient after the combined spinal epidural anesthesia.
【作者单位】：四川大学华西第二医院麻醉科;
【分类号】：R614

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