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首页> 外文期刊>Drug Design, Development and Therapy >Does an Earlier or Late Intravenous Injection of Ondansetron Affect the Dose of Phenylephrine Needed to Prevent Spinal-Anesthesia Induced Hypotension in Cesarean Sections?
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Does an Earlier or Late Intravenous Injection of Ondansetron Affect the Dose of Phenylephrine Needed to Prevent Spinal-Anesthesia Induced Hypotension in Cesarean Sections?

机译：ondansetron的较早或晚期静脉注射会影响预防脊髓麻醉诱导的剖宫产的低血压所需的剂量吗？

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Background: There was controversy about ondansetron can reduce the incidence of spinal-induced hypotension and decrease the consumption of vasopressor in cesarean delivery with spinal anesthesia. We hypothesized that different timing of ondansetron administration may contribute to the controversy. Therefore, we aimed to determine the effect of different timing of ondansetron administration on the dose requirement of preventing phenylephrine via comparing the ED50 of prophylactic phenylephrine. Methods: Seventy-five parturients were finally enrolled in this prospective, randomized, double-blinded dose finding study. Ondansetron or placebo was administered 5 min or 15 min before intrathecal injection. Up-down allocation method was used to determine the dose of prophylactic phenylephrine for each parturient in the three groups. The initial infusion rate of first patient was 0.5 μg/kg/min. Then, the rate for next patient was varied with increasing or decreasing of 0.05 μg/kg/min according to the response of the previous patient. An effective dose was defined as no hypotension occurred during the study period. An ineffective dose was defined as hypotension occurred during the study period. Study period in this study is from intrathecal injection to neonatal delivery. ED50 of phenylephrine infusion was calculated by probit regression. Results: The ED50 of intravenous phenylephrine calculated by probit analysis was 0.33 (95% CI 0.20 to 0.38) μg/kg/min and 0.36 (95% CI 0.32 to 0.38) μg/kg/min in group A and B, and 0.41 (95% CI 0.37 to 0.44) μg/kg/min in group C for patients undergoing cesarean delivery with combined spinal-epidural anesthesia. Conclusion: An earlier administration of 4 mg prophylactic ondansetron contributed no benefits for lowing the dose of prophylactic phenylephrine compared to a late administration, but can decrease the dose of preventing phenylephrine in patients undergoing cesarean delivery with combined spinal-epidural anesthesia. This finding may be useful for clinical practice and further studies.
机译：背景：关于ondansetron的争议可以降低脊柱诱导的低血压的发生率，并降低脊髓麻醉剖腹产的血管加压菌的消耗。我们假设ondansetron管理的不同时间可能有助于争议。因此，我们旨在确定ondansetron给药不同时序对预防苯妥的ED50通过比较预防苯妥的ED50来防止苯妥妥的剂量要求的影响。方法：七十五份群体最终纳入这项前瞻性，随机的双盲剂量发现研究。在鞘内注射前5分钟或15分钟给予ondansetron或安慰剂。上下分配方法用于确定三个组中每种级别的预防性苯妥的剂量。第一患者的初始输注速率为0.5μg/ kg / min。然后，根据前述患者的响应，随着下一个患者的速率随着0.05μg/ kg / min的增加或减少而变化。有效剂量定义为在研究​​期间没有发生过血压。无效剂量被定义为在研究​​期间发生的低血压。本研究的研究期是从鞘内注射到新生儿递送。通过探测回归计算苯妥肾上输注的ED50。结果：通过探测分析计算的静脉内苯妥的ED50为0.33（95％CI 0.20至0.38）μg/ kg / min，A和B组中的0.36（95％CI 0.32至0.38）μg/ kg / min，和0.41（ C组95％CI 0.37至0.44）μg/ kg / min，用于接受脊髓软件性麻醉组合剖腹产的患者。结论：早期给予4毫克预防性ondansetron的促进促使预防性苯肾上腺剂量的益处与晚期给药相比，可以降低预防脊髓软件性麻醉患者中患者的苯妥妥的剂量。这一发现可能对临床实践和进一步的研究有用。

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