剖宫产术中子宫适当收缩的平均最小剂量的比较。

IF 3.2 Q2 Pharmacology, Toxicology and Pharmaceutics Current clinical pharmacology Pub Date : 2019-01-01 DOI:10.2174/1574884714666190524100214
Siavash Beiranvand, Arash Karimi, Sepideh Vahabi, Arash Amin-Bidokhti
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引用次数: 23

摘要

背景:剖宫产是最常见的助产手术。本研究的目的是确定在剖宫产术中适当子宫收缩的平均最小剂量。方法:将患者分为择期剖宫产组(n=41)和难产剖宫产组(n=42)。患者接受脊髓麻醉,并开始以每分钟30滴的速度输注催产素(每1000毫升血清20单位催产素),同时也以半剂量的cc给药,以达到子宫的有效收缩。同时用问卷记录患者术中收缩压、舒张压(SBP、DBP)、心率、出血量等信息。结果:择期剖宫产组平均收缩压约117.10mmHg,平均舒张压70.50 mmHg,术中出血量623.63mL,心率88.88bpm。剖宫产组因产程困难,收缩压113.5 mmHg,舒张压62.69 mmHg,出血573.81mL。此外,择期组9例患者和无进展组3例患者不需要注射催产素。在无进展组中,8名患者需要5剂以上的催产素。此外,约10例(12%)患者无副作用和低血压。结论:择期剖宫产术中催产素最低有效剂量为1IU,产程中为1 ~ 1.5 iu,因此催产素用量越少,副作用越小。建议拟剖宫产的患者给予1.5IU的催产素丸剂。
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Comparison of the Mean Minimum Dose of Bolus Oxytocin for Proper Uterine Contraction during Cesarean Section.

Background: Cesarean section is the most common midwifery operation. The aim of this study is to determine the mean minimum dose of bolus oxytocin for proper uterine contraction during cesarean section.

Methods: Patients were divided into two groups: elective cesarean section (n=41) and cesarean section due to difficulty in labor (n=42 patients). Patients underwent spinal anesthesia and oxytocin infusion was begun at 30 drops per minute (20 units of oxytocin per 1000 cc serum), and was also administered as a half-dose in cc to achieve effective contraction of the uterus. Meanwhile, the information of patients including systolic and diastolic blood pressure (SBP and DBP), heart rate and amount of bleeding during the operation was recorded in a questionnaire.

Results: In the elective cesarean section group, the average SBP was about 117.10mmHg, average DBP 70.50 mmHg, the amount of bleeding during surgery was 623.63mL, and heart rate was 88.88bpm. In the cesarean section group due to difficulty in labor progress, SBP was 113.5 mmHg, DBP 62.69 mmHg, and bleeding was 573.81mL. In addition, 9 patients in the elective group and 3 patients in the lack of progress group, did not require bolus oxytocin. In the lack of a progress group, 8 patients needed more than 5 doses of oxytocin. In addition, about 10 (12%) of all patients had no side effects, and hypotension.

Conclusion: Given that, the minimum effective dose of oxytocin in the elective cesarean section was 1IU, and in those in labor progress was 1-1.5IU, less oxytocin administration represents lesser side effects. It is recommended that patients who are candidates of cesarean section should be administered 1.5IU of oxytocin in the form of bolus.

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Current clinical pharmacology
Current clinical pharmacology PHARMACOLOGY & PHARMACY-
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期刊介绍: Current Clinical Pharmacology publishes frontier reviews on all the latest advances in clinical pharmacology. The journal"s aim is to publish the highest quality review articles in the field. Topics covered include: pharmacokinetics; therapeutic trials; adverse drug reactions; drug interactions; drug metabolism; pharmacoepidemiology; and drug development. The journal is essential reading for all researchers in clinical pharmacology.
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