目的:本研究的目的是评估腰麻剖宫产术前碳水化合物负荷对硫醇和缺血修饰白蛋白(IMA)水平的影响。
方法:前瞻性,随机安慰剂对照研究。
方法:将在Karaman培训和研究医院计划在脊髓麻醉下进行剖宫产的79名孕妇随机分为对照组(C组)(n=42),和口服碳水化合物预负荷组(OCH组)(n=37)。OCH负荷需要在手术前一晚消耗400毫升,在麻醉前2小时内消耗200毫升。OCH组口服富含碳水化合物的饮料(Nutricia-Fantomalt),C组消耗等体积的水。这项研究调查了术前碳水化合物消耗后的硫醇-二硫化物稳态。术前胃液,volume,窦横截面积,出生后的低血压,各组比较胎儿血气参数。
结果:手术前后各组间硫醇和IMA水平无差异(P>.05)。胃超声检查显示两组之间的窦横截面积和胃体积相似(分别为P=0.172,P=0.128)。当手术引起低血压时,OCH组接受更多麻黄碱治疗手术引起的低血压,尽管这种差异没有统计学意义(P=.704)。带有内插线的聚类误差条(95%置信区间)图用于基于时间的比较组间心率和平均动脉压的平均差异。
结论:本研究支持剖宫产手术前母亲的硫醇和IMA水平不受手术前OCH负荷的影响。我们没有检查脐带血中的硫醇及其衍生物;因此,我们无法评论新生儿的硫醇/二硫化物稳态水平。
OBJECTIVE: The purpose of this study was to evaluate the effect of carbohydrate loading prior to the cesarean surgery under spinal anesthesia on thiols and ischemia-modified albumin (IMA) levels.
METHODS: Prospective, randomized placebo-controlled study.
METHODS: Seventy-nine pregnant women planned for cesarean sections under spinal anesthesia at Karaman Training and Research Hospital were randomized into a control group (group C) (n = 42), and an oral carbohydrate preloading group (group OCH) (n = 37). OCH loading requires consuming 400 mL the night before surgery and 200 mL up to 2 hours before anesthesia. Group OCH consumed an oral carbohydrate-rich beverage (Nutricia-Fantomalt), and group C consumed an equal volume of water. This study investigated thiol-disulfide homeostasis after preoperative carbohydrate consumption. Preoperative gastric fluid, volume, antral cross-sectional area, hypotension following the birth, and fetal blood gas parameters were compared across groups.
RESULTS: Thiols and IMA levels did not differ across groups before and after surgery (P > .05). Gastric ultrasonography showed similar antral cross-sectional area and stomach volume between groups (P = .172, P = .128, respectively). When surgery caused hypotension, group OCH received more ephedrine for surgery-induced hypotension, although this difference is not statistically significant (P = .704). A clustered error bar (95% confidence interval) plot with an interpolation line was used for a time-based comparison of mean differences in heart rate and mean arterial pressure between the groups.
CONCLUSIONS: This study supports that mothers\' thiols and IMA levels were unaffected by preoperative OCH loading before cesarean surgery. We did not examine thiol and its derivatives in umbilical cord blood; hence, we can not comment on thiol/disulfide homeostasis levels in neonates.