PDF(Pubmed)
Abstract：
Cesarean section often requires an urgent transfusion load due to decreased blood pressure after spinal anesthesia. This prospective randomized study aimed to investigate whether a preoperative oral rehydration solution (ORS) stabilized perioperative circulatory dynamics.
Sixty-three parturients scheduled for cesarean section under combined spinal epidural anesthesia (CSEA) were randomly allocated to one of three groups: Group O received 500 mL ORS before bedtime and 500 mL 2 h before CSEA; Group M received mineral water instead of ORS; and Group C had no fluid intake (controls). After entering the operating room, stomach size was measured using ultrasound. Blood samples were obtained, and CSEA was induced. Vasopressors were administered when systolic blood pressure was < 90 mmHg or decreased by > 20%. As a vasopressor, phenylephrine (0.1 mg) was administered at ≥ 60 beats/min heart rate or ephedrine (5 mg) at < 60 beats/min heart rate. The primary outcome was the total number of vasopressor boluses administered. Secondary outcomes were the cross-sectional area of the stomach antrum, maternal plasma glucose levels, serum sodium levels, total intravenous fluid, bleeding volume, urine volume, operative time, and cord blood gas values after delivery.
The total number of vasopressor boluses was lower in Group O than in Group C (P < 0.05). Group O had lower total dose of phenylephrine than Group C (P < 0.05). There were no significant differences between Group M and other groups. No differences were detected regarding secondary outcomes.
In women scheduled for cesarean section, preoperative ORS stabilized perioperative circulatory dynamics. Neither ORS nor mineral water consumption increased the stomach content volume.
This trial is registered in the University Hospital Medical Information Network Clinical Trials Registry (UMIN000019825: Date of registration 17/11/2015).
Sixty-three parturients scheduled for cesarean section under combined spinal epidural anesthesia (CSEA) were randomly allocated to one of three groups: Group O received 500 mL ORS before bedtime and 500 mL 2 h before CSEA; Group M received mineral water instead of ORS; and Group C had no fluid intake (controls). After entering the operating room, stomach size was measured using ultrasound. Blood samples were obtained, and CSEA was induced. Vasopressors were administered when systolic blood pressure was < 90 mmHg or decreased by > 20%. As a vasopressor, phenylephrine (0.1 mg) was administered at ≥ 60 beats/min heart rate or ephedrine (5 mg) at < 60 beats/min heart rate. The primary outcome was the total number of vasopressor boluses administered. Secondary outcomes were the cross-sectional area of the stomach antrum, maternal plasma glucose levels, serum sodium levels, total intravenous fluid, bleeding volume, urine volume, operative time, and cord blood gas values after delivery.
The total number of vasopressor boluses was lower in Group O than in Group C (P < 0.05). Group O had lower total dose of phenylephrine than Group C (P < 0.05). There were no significant differences between Group M and other groups. No differences were detected regarding secondary outcomes.
In women scheduled for cesarean section, preoperative ORS stabilized perioperative circulatory dynamics. Neither ORS nor mineral water consumption increased the stomach content volume.
This trial is registered in the University Hospital Medical Information Network Clinical Trials Registry (UMIN000019825: Date of registration 17/11/2015).
摘要：
背景：由于腰麻后血压下降，剖宫产通常需要紧急输血负荷。这项前瞻性随机研究旨在研究术前口服补液液（ORS）是否稳定围手术期循环动力学。
方法：将63例计划在腰硬联合麻醉（CSEA）下进行剖宫产的产妇随机分为三组之一：O组睡前接受500mLORS，CSEA前2h接受500mL；M组接受矿泉水代替ORS；C组没有液体摄入（对照组）。进入手术室后,使用超声波测量胃的大小。获得了血液样本，CSEA被诱导。当收缩压<90mmHg或降低>20%时,给予血管加压药。作为血管加压药,去氧肾上腺素（0.1mg）以≥60次/分钟的心率给药或麻黄碱（5mg）以<60次/分钟的心率给药。主要结果是给药的加压药的总数。次要结果是胃窦的横截面积，母体血浆葡萄糖水平，血清钠水平，总静脉输液,出血量,尿量,手术时间,分娩后脐带血气体值。
结果：O组的加压药总数低于C组（P<0.05）。O组去氧肾上腺素总剂量低于C组(P<0.05)。M组与其他组间差异无统计学意义。在次要结局方面没有检测到差异。
结论：在计划剖宫产的妇女中，术前ORS稳定围手术期循环动力学。ORS和矿泉水的消耗都不会增加胃内容物的体积。
背景：该试验在大学医院医学信息网络临床试验注册中心（UMIN000019825：注册日期2015-17-11）注册。
方法：将63例计划在腰硬联合麻醉（CSEA）下进行剖宫产的产妇随机分为三组之一：O组睡前接受500mLORS，CSEA前2h接受500mL；M组接受矿泉水代替ORS；C组没有液体摄入（对照组）。进入手术室后,使用超声波测量胃的大小。获得了血液样本，CSEA被诱导。当收缩压<90mmHg或降低>20%时,给予血管加压药。作为血管加压药,去氧肾上腺素（0.1mg）以≥60次/分钟的心率给药或麻黄碱（5mg）以<60次/分钟的心率给药。主要结果是给药的加压药的总数。次要结果是胃窦的横截面积，母体血浆葡萄糖水平，血清钠水平，总静脉输液,出血量,尿量,手术时间,分娩后脐带血气体值。
结果：O组的加压药总数低于C组（P<0.05）。O组去氧肾上腺素总剂量低于C组(P<0.05)。M组与其他组间差异无统计学意义。在次要结局方面没有检测到差异。
结论：在计划剖宫产的妇女中，术前ORS稳定围手术期循环动力学。ORS和矿泉水的消耗都不会增加胃内容物的体积。
背景：该试验在大学医院医学信息网络临床试验注册中心（UMIN000019825：注册日期2015-17-11）注册。
