Publication in refereed journal
香港中文大学研究人员 ( 现职)
| Professor Warwick Dean NGAN KEE (麻醉及深切治疗学系) |
全文
| 数位物件识别号 (DOI) http://dx.doi.org/10.1016/j.mpaic.2007.04.008 |
引用次数
Scopushttp://aims.cuhk.edu.hk/converis/portal/Publication/3Scopus source URL
其它资讯
摘要Hypotension is the most important common complication of regional anaesthesia for caesarean section. Methods of managing hypotension include lateral uterine displacement, mechanical leg compression, intravenous prehydration, and use of vasopressors. Uterine displacement is accepted as standard, although the optimal degree of tilt is unknown, and most anaesthetists overestimate the amount of tilt they believe they are applying. Leg compression is effective but not popular. In contrast to early reports, recent studies have not shown intravenous crystalloid prehydration to be very effective. Colloids are more effective but are expensive and have potential adverse effects. Rapid infusion of intravenous crystalloid after induction (cohydration) appears more effective than prehydration. Although historical studies supported use of ephedrine because of its low propensity to reduce uteroplacental blood flow, recent studies support use of α-agonists such as phenylephrine. Phenylephrine is more effective and can be titrated more easily than ephedrine, and it has a less depressive effect on fetal pH and base excess. It may be given as boluses (50-100 μg) or by infusion (50-100 μg/min). A phenylephrine infusion combined with cohydration is effective for preventing hypotension in most patients. Current evidence suggests that infusions are best titrated to maintain maternal blood pressure near to baseline values. ? 2007 Elsevier Ltd. All rights reserved.
着者Ngan Kee W.D.
期刊名称Anaesthesia and Intensive Care Medicine
出版年份2007
月份7
日期1
卷号8
期次7
出版社Medicine Pub. Co.
出版地United Kingdom
页次286 - 289
国际标準期刊号1472-0299
电子国际标準期刊号1878-7584
语言英式英语
关键词caesarean section, ephedrine, hypotension, phenylephrine, spinal anaesthesia, vasopressors
