本文選題：腰硬聯(lián)合麻醉 + 去氧腎上腺素　； 參考：《四川大學(xué)學(xué)報(bào)(醫(yī)學(xué)版)》2017年06期

【摘要】：目的研究去氧腎上腺素和間羥胺在預(yù)防剖宮產(chǎn)術(shù)腰硬聯(lián)合麻醉后低血壓的半數(shù)有效劑量(ED50),并計(jì)算二者等效比。方法 103例單胎足月孕擬行擇期剖宮產(chǎn)術(shù)患者分為去氧腎上腺素組(41例)和間羥胺組(62例)。常規(guī)行腰硬聯(lián)合麻醉,麻醉完成后即刻開始泵注試驗(yàn)用藥,去氧腎上腺素和間羥胺初始質(zhì)量濃度分別為1.0mg/100mL和2.0mg/100mL,固定輸注速率為100mL/h,試驗(yàn)采用序貫法決定下一病例藥物劑量,兩種藥物劑量梯度為0.05mg。觀察術(shù)中血壓、不良反應(yīng)及胎兒臍血血?dú)夥治鼋Y(jié)果。以術(shù)中觀察期間患者收縮壓低于基礎(chǔ)值80%或90mmHg(1mmHg=0.133kPa),定為該試驗(yàn)劑量無效,患者收縮壓≥基礎(chǔ)值,則視為該試驗(yàn)劑量有效。采用Probit回歸分析測量試驗(yàn)藥物的ED50及其95%可信區(qū)間(CI)。結(jié)果在試驗(yàn)條件下,維持剖宮產(chǎn)術(shù)腰硬聯(lián)合麻醉后血壓于基礎(chǔ)值水平所需去氧腎上腺素和間羥胺ED50分別為1.221 7mg(95%CI為1.099 1~1.593 7)和2.824 0mg(95%CI為2.658 9~3.433 6),兩種藥物等效比值為1∶2.3。術(shù)中兩種藥物副作用及兩組胎兒臍血血?dú)夥治霰容^差異無統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論以100mL/h持續(xù)泵注,維持產(chǎn)婦腰硬聯(lián)合麻醉后血壓于基礎(chǔ)水平所需的去氧腎上腺素和間羥胺ED50分別為1.221 7mg/100mL和2.824 0mg/100mL,二者等效比值為1∶2.3。
[Abstract]:Objective to study the median effective dose (ED50) of deoxyadrenaline and hydroxylamine in the prevention of caesarean section after combined spinal and epidural anesthesia, and to calculate the equivalent ratio of two cases. Methods 103 cases of single term single term pregnancy were divided into 41 cases (41 cases) and intervertebral hydroxylamine group (62 cases). The initial mass concentration of adrenaline and hydroxylamine was 1.0mg/100mL and 2.0mg/100mL, respectively, the initial mass concentration of adrenaline and hydroxylamine was 1.0mg/100mL and 2.0mg/100mL, and the fixed infusion rate was 100mL/h. The sequential method was used to determine the dosage of the next case. The two drug dose gradient was 0.05mg., the adverse reaction and fetal umbilical blood gas analysis results were observed. When the systolic pressure was lower than the base value of 80% or 90mmHg (1mmHg=0.133kPa) during the intraoperative observation, the test dose was invalid and the systolic pressure of the patient was more than the base value, which was considered to be the effective dose. Probit regression analysis was used to measure the ED50 of the test drug and its 95% confidence interval (CI). Deoxyadrenaline and hydroxylamine ED50 were 1.221 7Mg (95%CI 1.099 1~1.593 7) and 2.824 0mg (95%CI 2.658 9~3.433 6), respectively. The equivalent ratio of two kinds of drugs was 1: 2.3., and two groups of fetal umbilical blood gas analysis were not statistically significant (P0.05). The conclusion was 100. ML/h continued to pump, to maintain the essential level of deoxyadrenaline and interhydroxylamine ED50, 1.221 7mg/100mL and 2.824 0mg/100mL respectively, and the equivalent ratio of 1: 2.3. to the basic level of the parturient after the combined spinal epidural anesthesia.
【作者單位】： 四川大學(xué)華西第二醫(yī)院麻醉科;
【分類號(hào)】：R614

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