Oxytocin injection after Caesarean delivery: intravenous or intramyometrial?
Oxytocin injection after Caesarean delivery: intravenous or intramyometrial?
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DOI：
10.1007/bf03012092
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发表时间：
1998-07-01
期刊：
影响因子：
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通讯作者：
Sylvain, JP
中科院分区：
文献类型：
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作者：
Dennehy, KC;Rosaeg, OP;Sylvain, JP
目的：探讨剖宫产术后静脉注射和肌内注射催产素对子宫收缩功能和血压的影响。方法：将40例择期剖宫产产妇随机分为两组。鞘内注射0.75%布比卡因1.7ml和吗啡0.3 mg前静脉注射乳酸林格氏液1升。所有患者在去除胎盘后同时接受静脉注射和IMY注射。I组患者接受5IU(10IU。2组患者肌层注射生理盐水0.5ml，缩宫素20IU。在分娩前和注射研究溶液后每隔1分钟测量一次基线收缩压(SBP)和心率。分别于注射催产素后1、2、4、6、8、10、15min测定子宫收缩功能。结果：催产素治疗1分钟后，I组平均收缩压下降8.4 mm Hg，2组平均下降14.6 mm Hg(P<；0.001)。两组的子宫收缩能力和血红蛋白浓度变化相似。结论：剖宫产术后子宫肌层内注射20IU催产素与静脉注射5IU催产素相比，低血压更为严重。催产素注射途径不影响子宫张力。
Purpose: To determine, after Caesarean delivery, uterine contractility and blood pressure following intravenous (iv) and intramyometrial (imy) injection of oxytocin.Methods: In a double-blind clinical trial 40 parturients scheduled for elective Caesarean section with spinal anaesthesia were randomized into two equal groups. One litre Ringer's lactate was administered iv before intrathecal injection of 1.7 ml bupivacaine 0.75% and 0.3 mg morphine. All patients received simultaneous iv and imy injections after removal of the placenta. Patients in Group I received 5 IU (10 IU . ml(-1)) oxytocin iv and 2 ml saline imy; Group 2 patients received 0.5 ml saline iv and 20 IU oxytocin into the myometrium. Baseline systolic blood pressure (SBP) and heart rate were measured before delivery and at one minute intervals for 15 min after injection of study solutions. Uterine contractility was assessed at 1, 2, 4, 6, 8, 10 and 15 min after oxytocin injection. Haemoglobin concentration before surgery and on first post-operative day was also recorded.Results: Mean decrease in systolic blood pressure (SBP) one minute after oxytocin was 8.4 mmHg in Group I vs 14.6 mmHg in Group 2 (P < 0.001). Systolic blood pressure returned to baseline two minutes after oxytocin in Group I and after three minutes in Group 2. Uterine contractility and change in haemoglobin concentration were similar in both groups.Conclusion: Intramyometrial administration of 20 IU oxytocin after Caesarean delivery is associated with more severe hypotension than is iv injection of 5 IU oxytocin. Route of oxytocin injection did not affect uterine tone.