Effect of preadministration phenylephrine on the hemodynamics result from oxytocin during cesarean section
10.3760/cma.j.issn.1673-4904.2013.18.012
- VernacularTitle:防御性应用去氧肾上腺素对缩宫素诱发剖宫产术患者血流动力学的影响
- Author:
Chuanbao HAN
;
Xiuhong JIANG
;
Li YU
- Publication Type:Journal Article
- Keywords:
Oxytocin;
Phenylephrine;
Haemodynamics;
Cesarean section
- From:
Chinese Journal of Postgraduates of Medicine
2013;(18):35-38
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the effect of preadministration phenylephrine on the hemodynamics result from oxytocin during caesarean section.Methods One hundred parturients,ASA Ⅰ-Ⅱ,with single baby at full term in vertex presentation scheduled for cesarean section under continuous epidural anesthesia were randomly divided into 4 groups,each group was 25 cases.All parturients received injection 10 U of oxytocin in the uterus after delivery,followed by an oxytocin rapid infusion of 10 U (less than 5 min),meanwhile,through the other intravenous channel,injection of phenylephrine 1 μ g/kg in group 1,2 μ g/kg in group Ⅱ,3 μ g/kg in group Ⅲ,while injection of 0.9％ sodium chloride 1 ml in groupⅣ as control.The mean arterial pressure (MAP) and heat rate (HR) at preanesthesia (T0),the time of oxytocin injection after dehvery (T1) and after oxytocin injection 30 s (T2),1 ain (T3),3 min (T4),5 ain (T5),10 min(T6) was recorded.Results There were no significant difference in MAP at T0 and clinical data among the groups (P ＞ 0.05).The level of MAP in group Ⅰ and Ⅳ at T3-T5 was significantly lower than that at T0[(82 ± 7),(79 +5),(83 ± 6) mm Hg(1 mm Hg =0.133 kPa) vs.(90 ± 7) mm Hg,(84 ±7),(76 ± 5),(82 ±7) mm Hg vs.(91 ±7) mm Hg] (P ＜0.05).The level of MAP in group Ⅲ at T2-T3 was significantly higher than that at T0[(93 ± 8),(103 ± 10)mm Hg vs.(91 ± 8) mm Hg] (P ＜ 0.05).Compared with group Ⅳ,the level of MAP in group Ⅱ at T3-T5 was significantly higher,the level of MAP in group Ⅲ at T2-T5 was significantly higher,there was significant difference (P ＜0.05).The level of HR had no significant difference in T0 among the groups (P ＞ 0.05).The level of HR in four groups at T3-T5 was significantly higher than that at T0[(98 + 12),(105 + 12),(96 + 9) times/ain vs.(79 ± 8) times/ain,(89 ± 10),(96 ± 13),(92 + 12) times/min vs.(80 ± 11) times/min,(88 ± 10),(94 ± 12),(90 ± 9) times/min vs.(83 ± 10) times/min,(94 ± 12),(112 ± 13),(102 ± 1 1) times/ain vs.(82 ± 9) times/min](P ＜ 0.05 or ＜ 0.01),and reached to peak value at T4(P＜ 0.01),then gradually declined to the baseline values (T1) except in group Ⅳ at T6.Compared with group Ⅳ,the level of HR in group Ⅲ and group Ⅲ was significantly decreased at T4-T5(P ＜ 0.05).The rate of MAP decrease range above 30％ in group Ⅳ was 24％(6/24),and significantly higher than that in group Ⅱ (0) and group Ⅲ (0),there was significant difference(P＜ 0.05).The rate of nausea in group Ⅳ was significantly higher than that in group Ⅱ and group Ⅲ,there was significant difference (P ＜0.05).The scores of Apgar scale after delivery 1,5 min had no significant difference among four groups (P ＞0.05).Conclusion Haemodynamic stability can be obtained by administration 2 μ g/kg of phenylephrine when parturients received injection 10 U of oxytocin in the uterus after delivery,and followed by an oxytocin rapid infusion of 10 U during cesarean section.
