在晶体中添加1%葡萄糖对剖宫产脊髓麻醉后产妇血流动力学的影响:一项双盲、随机临床试验

Samira Saghravanian, Masoomeh Tabari, Monavar Afzalaghaee, Shima Sheybani
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引用次数: 0

摘要

背景:我们的目的是评估麻醉诱导前含葡萄糖晶体输注对血流动力学和麻醉后并发症的影响。方法:对伊朗马什哈德医科大学附属教学医院转介的60例脊髓麻醉下择期剖宫产患者进行双盲、随机临床试验。将产妇随机分为两组。两组脊髓麻醉前静脉注射血清5 ~ 7ml /kg。含糖生理盐水(GcNS)组给予1%葡萄糖溶液加生理盐水。生理盐水(NS)组仅给予生理盐水。评估收缩压(SBP)、舒张压(DBP)、心率(HR)、血糖浓度、新生儿Apgar评分、麻醉后并发症以及麻黄碱和阿托品的消耗。结果:共招募患者60例(每组30例),GcNS组和NS组平均年龄分别为29.14±6.01岁和29.76±6.15岁。在基线调整后,两组在收缩压、舒张压或心率方面无显著差异。NS组低血压发生率(70.0%)高于GcNS组(46.6%),但差异无统计学意义。Apgar评分差异无统计学意义。NS组的恶心、呕吐、苍白和颤抖发生率较高。然而,麻醉诱导后10分钟只有恶心和呕吐明显。麻黄碱和阿托品的摄入量在NS组较高,但不显著。结论:目前的研究没有显示在生理盐水预负荷中添加1%葡萄糖对脊柱麻醉剖宫产的低血压患者有任何明显的益处。
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The Effect of Adding 1% Glucose to Crystalloid on Maternal Hemodynamics After Spinal Anesthesia for Cesarean Delivery: A Double-Blind, Randomized Clinical Trial
Background: We aimed to evaluate the effect of glucose-containing crystalloid infusion before anesthesia induction on hemodynamics and postanesthesia complications. Methods: This double-blind, randomized clinical trial was conducted on 60 parturient cases scheduled for elective Cesarean delivery under spinal anesthesia who were referred to the teaching hospitals of Mashhad University of Medical Sciences (Iran). The parturients were randomized into two groups. Both groups received 5 - 7 mL/kg of intravenous bolus serum before spinal anesthesia. The parturients in the glucose-containing normal saline (GcNS) group received 1% glucose solution in normal saline. The normal saline (NS) group received only normal saline. Systolic blood pressure (SBP), diastolic blood pressure (DBP), heart rate (HR), blood glucose concentrations, neonatal Apgar scores, postanesthesia complications, and ephedrine and atropine consumption were evaluated. Results: Sixty patients were recruited (30 in each group), with a mean age of 29.14 ± 6.01 and 29.76 ± 6.15 years in the GcNS and NS groups, respectively. There was no significant difference between the two groups in SBP, DBP, or HR after baseline adjustment. The incidence of hypotension was higher in the NS (70.0%) compared to the GcNS group (46.6%), but the difference was not significant. There was no significant difference in Apgar scores. The incidence of nausea, vomiting, pallor, and shivering was higher in the NS group. However, only nausea and vomiting 10 minutes after anesthesia induction were significant. Ephedrine and atropine consumption was higher in the NS group, but not significantly. Conclusions: The present study did not show any clear benefit for adding 1% glucose to normal saline solution preload for hypotension in parturients undergoing Cesarean delivery with spinal anesthesia.
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