硝苯地平在剖宫产先兆子痫中的应用

Y J Hong, C F Lin, J C Chen, P Pan, K L Wong, T T Wei
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引用次数: 0

摘要

子痫前期患者急诊剖宫产对麻醉医师来说一直是一个挑战,因为喉镜检查和气管插管后严重的高血压反应可能导致脑出血等危及生命的并发症。这些患者大多接受硫酸镁治疗以预防惊厥。理想的降压药应具有降压效果好、降压幅度小、起效快、维持子宫胎盘血流、对母体和胎儿的副作用小等特点。我们研究了10mg舌下硝苯地平对减轻插管加压反应的疗效。我们也担心这种钙拮抗剂与硫酸镁和全身麻醉一起使用时是否会抑制子宫收缩,增加子宫内和产后出血。本研究共33例患者,其中硝苯地平组16例,对照组17例。本研究显示硝苯地平能有效减轻高血压反应。两组对催产素药物均有良好的子宫收缩反应。硝苯地平组与对照组出血量差异无统计学意义。且无严重的母婴不良反应。
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[Nifedipine in preeclampsia for cesarean section].

The patients with preeclampsia undergoing emergent cesarean section is always a challenge to an anesthesiologist, because severe hypertensive response after laryngoscopy and tracheal intubation may result in life-threatening complication such as cerebral hemorrhage. Most of these patients receive magnesium sulfate for the prevention of convulsion. An ideal anti-hypertensive drug for preeclampsia should be effective, limited fall in blood pressure, rapid onset, maintaining uteroplacental blood flow, and less maternal and fetal side effects. We studied the efficacy of 10 mg sublingual nifedipine in attenuating the pressor response to intubation. We were also concerned about whether this calcium antagonist may inhibit uterine contraction and increase intra and postpartum hemorrhage when it is used with magnesium sulfate and general anesthesia. There were thirty-three patients in our study (16 in nifedipine group and 17 in control group). This study revealed that nifedipine attenuate the hypertensive response effectively. Uterine contraction response to oxytocic drugs was quite well in both groups. There was no significant difference in blood loss between nifedipine and control group. And no severe maternal and fetal adverse effect.

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Prolonged fasting in pediatric outpatients does not cause hypoglycemia. Continuous succinylcholine infusion and phase II block in short surgical procedures. [Pheochromocytoma]. [Anesthetic management of intraoperatively diagnosed pheochromocytoma--a case report]. [Postoperative hypoglycemia after pheochromocytoma resection].
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