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首页> 外文期刊>Current opinion in anaesthesiology >Oxytocin for labour and caesarean delivery: implications for the anaesthesiologist.
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Oxytocin for labour and caesarean delivery: implications for the anaesthesiologist.

机译：催产素用于分娩和剖腹产：对麻醉医师的意义。

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PURPOSE OF REVIEW: The implications of the obstetric use of oxytocin for obstetric anaesthesia practice are summarised. The review focuses on recent research on the uterotonic effects of oxytocin for prophylaxis and management of uterine atony during caesarean delivery. RECENT FINDINGS: Oxytocin remains the first-line agent in the prevention and management of uterine atony. In-vitro and in-vivo studies show that prior exposure to oxytocin induces uterine muscle oxytocin receptor desensitization. This may influence oxytocin dosing for adequate uterine tone following delivery. Oxytocin has important cardiovascular side-effects (hypotension, tachycardia and myocardial ischaemia). Recent studies suggest that the effective dose of oxytocin for prophylaxis against uterine atony during caesarean delivery is significantly lower than the 5-10 IU historically used by anaesthesiologists. Slow administration of small bolus doses of oxytocin minimises maternal haemodynamic disturbance. Continuous oxytocin infusions are recommended for maintaining uterine tone after bolus administration, although ideal infusion rates are still to be established. The efficacy of the long-acting oxytocin analogue carbetocin requires further investigation. Recommendations are presented for oxytocin dosing during caesarean delivery. SUMMARY: Oxytocin remains the first-line uterotonic after vaginal and caesarean delivery. Recent research elucidates the therapeutic range of oxytocin during caesarean delivery, as well as receptor desensitization. Evidenced-based protocols for the prevention and treatment of uterine atony during caesarean delivery are recommended.
机译：审查目的：总结了在产科麻醉实践中产科使用催产素的意义。这篇综述集中在催产素在子宫剖宫产过程中预防和控制子宫收缩乏力的子宫收缩作用方面的最新研究。最新发现：催产素仍然是预防和控制子宫收缩乏力的一线药物。体外和体内研究表明，事先暴露于催产素会引起子宫肌催产素受体脱敏。这可能会影响催产素剂量，以确保分娩后有足够的子宫张力。催产素具有重要的心血管副作用（低血压，心动过速和心肌缺血）。最近的研究表明，催产素在剖腹产过程中预防子宫收缩乏力的有效剂量明显低于麻醉医师以往使用的5-10 IU。缓慢给予小剂量的催产素可以最大程度地降低孕妇的血流动力学紊乱。尽管仍需确定理想的输注速度，但建议连续催产素输注以维持大剂量给药后的子宫张力。长效催产素类似物卡比妥星的功效需要进一步研究。提出了在剖腹产过程中服用催产素的建议。总结：催产素在阴道和剖腹产后仍然是一线子宫收缩剂。最近的研究阐明了剖宫产过程中催产素的治疗范围以及受体脱敏。推荐在剖腹产时预防和治疗子宫收缩乏力的循证方案。

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