摘要
目的观察剖宫产术中依心率变化预给去甲肾上腺素预防低血压的效果。方法择期行硬膜外下剖宫产术单胎足月孕妇56例均分为两组,连续监测麻醉前和麻醉后仰卧位1、4、7、10、13、16min时的无创血压与心率。在麻醉后仰卧位时心率超过基础心率的20%时(A组)或在SBP降低超过基础值20%时(B组),静脉给予去甲肾上腺素4μg。记录去甲肾上腺素的使用率,观察不良反应的发生情况。结果两组产妇在麻醉后仰卧位7min时,A组SBP高于B组[(115±12)mmHg vs.(95±12)mmHg](P<0.05);两组各时间点心率变化差异无统计学意义(P>0.05)。两组去甲肾上腺素使用率相仿[38.5%(10/26)vs.36.0%(9/25)](P>0.05)。A组产妇头晕、恶心、心慌胸闷的不良反应发生率低于B组(P<0.01)。结论剖宫产术中依心率变化预给去甲肾上腺素能及时有效预防低血压,从而减少不良反应的发生。
Objective To observe the efficacy of heart rate （HR ）-based norepinephrine pretreatment in preventing hypotension during Caesarean section .Methods Caesarean section under epidural anesthesia was performed in 56 pregnant women with single birth ,who were equally divided into two groups .The HR and non-invasive blood pressure on supine position were recorded before and at 1 ,4 ,7 ,10 ,13 and 16 minutes after anesthesia .The pretreatment with intravenous injection of norepinephrine 4μg was carried out when HR was increased more than 20% of the baseline（group A） or SBP was lower than 20% of the baseline（group B） .The frequency of norepinephrine injection was calculated .The incidences of adverse effects were observed .Results The SBP at 7 minutes after anesthesia was higher in group A than that in group B[（115 ± 12） mmHg vs .（95 ± 12） mmHg] （P〈0 .05） .The changes of HR during observing period were not significantly different between two groups（P〉0 .05） .The frequency of norepinephrine injection of two groups was similar [38.5% （10/26） vs . 36.0% （9/25）]（P〉0 .05） .The incidences of dizziness ,nausea ,panic and chest distress were lower in group A than those in group B（P＆lt;0 .01） .Conclusion HR-based norepinephrine pretreatment during Caesarean section under epidural anesthesia may prevent hypotension timely and effectively ,which is helpful in reducing adverse effects of the puerpera undergoing Caesarean section .
出处
《江苏医药》
CAS
2017年第21期1542-1545,共4页
Jiangsu Medical Journal
关键词
剖宫产
心率
去甲肾上腺素
低血压
Caesarean section
Heart rate
Norepinephrine
Hypotension
