So sánh hiệu quả dự phòng tụt huyết áp của noradrenalin với ephedrin truyền tĩnh mạch sau gây tê tủy sống mổ lấy thai=Comparision the effectiveness of the hypotension prevention and treatment after spinal anesthesia for cesarean section by noradrenalin with ephedrin continuous intravenous infusion

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Tác giả: Hữu Hùng Bùi, Xuân Hải Tăng, Minh Long Trần

Ngôn ngữ: vie

Ký hiệu phân loại:

Thông tin xuất bản: Y học cộng đồng, 2023

Mô tả vật lý: tr.267-272

Bộ sưu tập: Metadata

ID: 477596

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So sánh hiệu quả dự phòng tụt huyết áp của noradrenalin với ephedrin truyền tĩnh mạch sau tê tủy sống mổ lấy thai. Phương pháp nghiên cứu: Mô tả lâm sàng ngẫu nhiên có so sánh. Có 120 BN GTTS mổ lấy thai phân chia ngẫu nhiên 2 nhóm bằng nhau. Trình tự tiến hành: Cả hai nhóm được truyền dịch tinh thể trước GTTS liều 10 ml/kg. GTTS khe L3-4. Liều bupivacain theo chiều cao (7,5mg- 8,5mg). Ở nhóm I: Truyền noradrenalin liều 0,05 mcg/kg/phút sau GTTS và bolus 5 mcg/lần khi HA tụt. Ở nhóm II: Truyền epheddrin liều 0,05 mg /kg / phút sau GTTS và bolus 5mg/lần khi HA tụt. Truyền xong oxytoxin trước khi dừng truyền liên tục. Đánh giá: Thay đổi HA, nhịp tim, liều thuốc co mạch, thông số dịch truyền. Kết quả: HA nhóm I ổn định hơn so với nhóm II, số đợt tăng HA nhóm I ít hơn nhóm II. Số BN bolus ở nhóm I (20%) ít hơn nhóm II (48,3 %). Nhịp tim nhóm I thấp hơn nhóm II, số đợt mạch nhanh nhóm I thấp hơn nhóm II. Tổng liều noradrenaline nhóm I (28,5 ± 8 mcg) và ở nhóm II (20,95 ± 9 mg). Lượng dịch truyền sau gây tê nhóm I (655,1 ± 136 ml) ít hơn nhóm II (786,8 ± 108,5 ml) với p<
0,05. Kết luận: Hiệu quả dự phòng tụt HA của truyền noradrenaline tốt hơn, nhịp tim ổn đinh hơn, cần dùng liều bolus, dịch truyền ít hơn truyền ephedrin.To compare the effectiveness of the hypotension prevention and treatment after spinal anesthesia for cesarean section by noradrenalin with ephedrin continuous intravenous infusion. Methods: Comparative randomized clinical description. With 120 patients who received spinal anesthesia for cesarean section were randomly assigned to 2 equal groups. Procedure: Both groups received crystalloid infusion before spinal anesthesia with a dose of 10 ml/kg. Spinal anesthesia at the L3-4 vertebral interspace. Bupivacaine dose according to height (7.5 mg- 8.5 mg). Group I: Received a noradrenaline continuous infusion at a dose of 0.05 mcg/kg/min after spinal anesthesia and received bolus 5 mcg/time every hypotension time. In group II: Received a ephedrin continuous infusion at a dose of 0.05 mg/kg/min and both groups had treated for hypotension at 1 ml (5 mcg/ml noradrenalin or 5 mg/ml ephedrin) 1 min apart until blood pressure returned to normal. We had finished the oxytoxin infusion when we stopped the continuous infusion. Evaluation: Heart rates, the changes of blood pressure, noradrenaline doses, fluid parameters, ephedrine doses. Results: Blood pressure of group I was more stable than that of group II. The number of bolus patients in group I (20%) was less than group II (48.3%). Group I heart rate was lower than group II, The number of tachycardia episodes in group I was lower than in group II. The total dose of noradrenaline in group I was (28.5 ± 8 mcg) and in group II (20.95 ± 9 mg. The amount of fluid after spinal anesthesia in group I (655.1 ± 136 ml) was less than group II (786.8 ± 108.5 ml) with p<
0,05. Conclusion: The preventive hypotension effect of noradrenaline infusion was better than ephedrin infusion, The heart rate of group noradrenalin was more stable than group ephedrin. The bolus dose of group noradrenalin was less than that of group ephedrin. The infusion fluid of group noradrenalin was less than that of group ephedrin.

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