腹膜下阻滞剖宫产术中静脉注射卡贝菌素与催产素对血流动力学影响的比较

IF 0.2 Q4 ANESTHESIOLOGY
V. Jannu, Meghana Hanagandi, Raghavendra Kalal, C. Sabari
{"title":"腹膜下阻滞剖宫产术中静脉注射卡贝菌素与催产素对血流动力学影响的比较","authors":"V. Jannu, Meghana Hanagandi, Raghavendra Kalal, C. Sabari","doi":"10.4103/JOACC.JOACC_28_23","DOIUrl":null,"url":null,"abstract":"Context: Uterine atony is the commonest cause for postpartum haemorrhage in majority of cases. Oxytocin remains the first-line uterotonic agent but, is associated with significant cardiovascular effects like hypotension and tachycardia after intravenous administration. Carbetocin, a synthetic heat-stable oxytocin analogue combines the safety and efficacy profile of oxytocin with the sustained uterotonic activity. Aims: The aim of this study was to compare intravenous oxytocin and carbetocin for haemodynamic responses during caesarean section under subarachnoid block. Settings and Design: Randomized controlled trial. Methods and Material: We performed a prospective randomized, controlled study on 142 pregnant patients undergoing elective cesarean section under subarachnoid block. Patients were randomly assigned to receive either 3U of intravenous oxytocin followed by infusion of 10U/hour for 4 hours or 100 μg intravenous carbetocin after the delivery of anterior shoulder. Heart rate and mean intra-arterial blood pressures were recorded at every 15 s during the study period of 5 min. Statistical Analysis Used: Data were analyzed using Student's unpaired test, Chi-squared test, and Fischer's exact test. A P < 0.05 was considered statistically significant. Results: Oxytocin produced clinically significant tachycardia (>20%) with peak effects over 180 s after injection (P < 0.0001). It also demonstrated a significant decrease in mean arterial pressure within 30 s of bolus injection and hypotension persisted throughout the study period (P < 0.0001). Carbetocin produced no significant changes in heart rate and mean blood pressure responses. The requirement of additional uterotonics and total intraoperative blood loss were similar among both the groups. Conclusions: Intravenous carbetocin is better tolerated without significant haemodynamic adverse effects in comparison to oxytocin during cesarean section.","PeriodicalId":16611,"journal":{"name":"Journal of Obstetric Anaesthesia and Critical Care","volume":null,"pages":null},"PeriodicalIF":0.2000,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Comparison of haemodynamic effects of intravenous carbetocin and oxytocin during caesarean section under subarchanoid block\",\"authors\":\"V. Jannu, Meghana Hanagandi, Raghavendra Kalal, C. Sabari\",\"doi\":\"10.4103/JOACC.JOACC_28_23\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"Context: Uterine atony is the commonest cause for postpartum haemorrhage in majority of cases. Oxytocin remains the first-line uterotonic agent but, is associated with significant cardiovascular effects like hypotension and tachycardia after intravenous administration. Carbetocin, a synthetic heat-stable oxytocin analogue combines the safety and efficacy profile of oxytocin with the sustained uterotonic activity. Aims: The aim of this study was to compare intravenous oxytocin and carbetocin for haemodynamic responses during caesarean section under subarachnoid block. Settings and Design: Randomized controlled trial. Methods and Material: We performed a prospective randomized, controlled study on 142 pregnant patients undergoing elective cesarean section under subarachnoid block. Patients were randomly assigned to receive either 3U of intravenous oxytocin followed by infusion of 10U/hour for 4 hours or 100 μg intravenous carbetocin after the delivery of anterior shoulder. Heart rate and mean intra-arterial blood pressures were recorded at every 15 s during the study period of 5 min. Statistical Analysis Used: Data were analyzed using Student's unpaired test, Chi-squared test, and Fischer's exact test. A P < 0.05 was considered statistically significant. Results: Oxytocin produced clinically significant tachycardia (>20%) with peak effects over 180 s after injection (P < 0.0001). It also demonstrated a significant decrease in mean arterial pressure within 30 s of bolus injection and hypotension persisted throughout the study period (P < 0.0001). Carbetocin produced no significant changes in heart rate and mean blood pressure responses. The requirement of additional uterotonics and total intraoperative blood loss were similar among both the groups. Conclusions: Intravenous carbetocin is better tolerated without significant haemodynamic adverse effects in comparison to oxytocin during cesarean section.\",\"PeriodicalId\":16611,\"journal\":{\"name\":\"Journal of Obstetric Anaesthesia and Critical Care\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":0.2000,\"publicationDate\":\"2023-07-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Obstetric Anaesthesia and Critical Care\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.4103/JOACC.JOACC_28_23\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q4\",\"JCRName\":\"ANESTHESIOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Obstetric Anaesthesia and Critical Care","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.4103/JOACC.JOACC_28_23","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"ANESTHESIOLOGY","Score":null,"Total":0}
引用次数: 0

摘要

背景:在大多数情况下,子宫收缩乏力是产后出血的最常见原因。催产素仍然是一线子宫紧张药,但与静脉注射后的低血压和心动过速等显著心血管影响有关。卡贝托星是一种合成的热稳定催产素类似物,它将催产素的安全性和有效性与持续的子宫收缩活性相结合。目的:本研究的目的是比较蛛网膜下腔阻滞下剖宫产期间静脉注射催产素和卡贝托星的血液动力学反应。设置和设计:随机对照试验。方法和材料:我们对142例蛛网膜下腔阻滞下选择性剖宫产的孕妇进行了前瞻性随机对照研究。患者被随机分配接受3U的静脉注射催产素,然后以10U/小时的速度输注4小时,或在前肩分娩后接受100μg的静脉注射卡贝托星。在5分钟的研究期间,每15秒记录一次心率和平均动脉内血压。使用的统计分析:使用Student的非配对检验、卡方检验和Fischer的精确检验分析数据。P<0.05被认为具有统计学意义。结果:催产素引起临床上显著的心动过速(>20%),在注射后180 s内达到峰值(P<0.0001)。它还表明,在推注后30 s内,平均动脉压显著降低,低血压在整个研究期间持续存在(P<0.001)。卡贝托星对心率和平均血压反应没有产生显著变化。两组患者对额外子宫收缩剂的需求和术中总失血量相似。结论:与剖宫产期间的催产素相比,静脉注射卡贝托星的耐受性更好,没有显著的血液动力学不良反应。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Comparison of haemodynamic effects of intravenous carbetocin and oxytocin during caesarean section under subarchanoid block
Context: Uterine atony is the commonest cause for postpartum haemorrhage in majority of cases. Oxytocin remains the first-line uterotonic agent but, is associated with significant cardiovascular effects like hypotension and tachycardia after intravenous administration. Carbetocin, a synthetic heat-stable oxytocin analogue combines the safety and efficacy profile of oxytocin with the sustained uterotonic activity. Aims: The aim of this study was to compare intravenous oxytocin and carbetocin for haemodynamic responses during caesarean section under subarachnoid block. Settings and Design: Randomized controlled trial. Methods and Material: We performed a prospective randomized, controlled study on 142 pregnant patients undergoing elective cesarean section under subarachnoid block. Patients were randomly assigned to receive either 3U of intravenous oxytocin followed by infusion of 10U/hour for 4 hours or 100 μg intravenous carbetocin after the delivery of anterior shoulder. Heart rate and mean intra-arterial blood pressures were recorded at every 15 s during the study period of 5 min. Statistical Analysis Used: Data were analyzed using Student's unpaired test, Chi-squared test, and Fischer's exact test. A P < 0.05 was considered statistically significant. Results: Oxytocin produced clinically significant tachycardia (>20%) with peak effects over 180 s after injection (P < 0.0001). It also demonstrated a significant decrease in mean arterial pressure within 30 s of bolus injection and hypotension persisted throughout the study period (P < 0.0001). Carbetocin produced no significant changes in heart rate and mean blood pressure responses. The requirement of additional uterotonics and total intraoperative blood loss were similar among both the groups. Conclusions: Intravenous carbetocin is better tolerated without significant haemodynamic adverse effects in comparison to oxytocin during cesarean section.
求助全文
通过发布文献求助,成功后即可免费获取论文全文。 去求助
来源期刊
自引率
0.00%
发文量
37
审稿时长
29 weeks
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信