Effects of nitrous oxide/oxygen inhalation on the maternal circulation during vaginal delivery
Effects of nitrous oxide/oxygen inhalation on the maternal circulation during vaginal delivery
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阴道分娩时吸入一氧化二氮/氧气对母体循环的影响
DOI：
10.1111/j.1399-6576.1992.tb03447.x
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发表时间：
1992
期刊：
影响因子：
--
通讯作者：
B. Ekström‐Jodal
中科院分区：
文献类型：
--
作者：
F. Westling;I. Milsom;H. Zetterström;B. Ekström‐Jodal
研究了24例健康孕妇在分娩第一阶段吸入不同氧化亚氮/氧气（N2O/O2）混合气体（间歇70/30、40/60、0/100和连续40/60）时的血流动力学变化。心输出量由宫缩前的6.6±0.2 1/min增加至宫缩时的8.5±0.3 1/min （P<0.01）。与两次收缩之间的测量结果相比，收缩期间的心率、卒中容量、收缩压、舒张压和平均动脉压升高（P<0.01），周围血管总阻力降低（P<0.01）。N2O/O2的使用对母体循环有影响。在间歇吸入时，较高浓度的N2O与心率、心输出量和动脉压降低（P<0.01）以及卒中量增加（P<0.01）相关。随着吸入氧化亚氮浓度的增加，疼痛缓解程度也增加（P<0.01）。子宫收缩期间间歇吸入对循环的影响在两次宫缩间隔期间也很明显，但没有给予N2O/O2。连续吸入N2O/O2对循环和疼痛的影响最为明显。镇痛作用和心血管作用之间有密切的联系，表明后者，至少部分是由于疼痛缓解。然而，无法排除或证实N2O/O2对母体循环可能的直接药理作用。
The hemodynamic changes occurring during the first stage of labor were studied in 24 healthy pregnant women during inhalation of different nitrous oxide/oxygen (N2O/O2) gas mixtures (intermittent 70/30, 40/60, 0/100 and continuous 40/60). Cardiac output increased (P<0.01) from 6.6 ± 0.2 1/min between uterine contractions to 8.5 ± 0.3 1/min during contractions. Heart rate, stroke volume, systolic, diastolic and mean arterial pressures were increased (P<0.01) and total peripheral vascular resistance was reduced (P<0.01) during contractions compared to measurements performed between contractions. The maternal circulation was influenced by the use of N2O/O2. During intermittent inhalation, higher concentrations of N2O were associated with a decrease (P<0.01) in heart rate, cardiac output and arterial pressure as well as an increase (P<0.01) in stroke volume. The degree of pain relief also increased (P<0.01) with increasing concentrations of inhaled nitrous oxide. The circulatory influence of intermittent inhalation given during uterine contractions was also apparent during the interval between contractions when N2O/O2 was not administered. The most obvious effects on both circulation and pain were demonstrated during continuous inhalation of N2O/O2. There was a close association between analgetic and cardiovascular effects indicating that the latter, at least partly, were due to pain relief. However, it was not possible to exclude or confirm possible direct pharmacological effects of N2O/O2 on maternal circulation.