...
  • 主题
高级搜索  >
历史搜索 清空历史
首页> 外文期刊>Current opinion in anaesthesiology >Vasopressors in obstetrics: what should we be using?
【24h】

Vasopressors in obstetrics: what should we be using?

机译：产科血管加压药：我们应该使用什么？

获取原文
获取原文并翻译 | 示例
           
页面导航
  • 摘要
  • 著录项
  • 相似文献
  • 相关主题

摘要

PURPOSE OF REVIEW: Historically, ephedrine has been recommended as the best vasopressor in obstetrics because animal studies showed it caused less reduction in uterine blood flow compared with alpha-agonists. Recent clinical evidence, however, suggests that this is not as important as initially thought. This review evaluates current data with a focus on spinal anesthesia for cesarean section. RECENT FINDINGS: Ephedrine and phenylephrine have been most investigated. Advantages of ephedrine include familiarity, long history and low propensity for uteroplacental vasoconstriction. Ephedrine, however, has limited efficacy, is difficult to titrate, causes maternal tachycardia and depresses fetal pH and base excess. Advantages of phenylephrine include high efficacy, ease of titration and the ability to use liberal doses to maintain maternal blood pressure near normal and then prevent nausea and vomiting without causing fetal acidosis. Phenylephrine, however, may decrease maternal heart rate and cardiac outputand few data are available on its use in high-risk cases. Combination of a phenylephrine infusion and rapid crystalloid cohydration is the first method described that reliably prevents hypotension. SUMMARY: When current evidence is considered, in the authors' opinion, phenylephrine is the vasopressor that most closely meets the criteria for the best vasopressor in obstetrics.
机译：审查目的：历史上，麻黄碱被推荐为产科中最好的升压药，因为动物研究表明，与α-激动剂相比，麻黄碱引起的子宫血流减少较少。然而，最近的临床证据表明，这并不像最初想象的那么重要。这篇评论评估当前的数据，重点是剖宫产的脊柱麻醉。最近的发现：麻黄碱和去氧肾上腺素研究最多。麻黄碱的优点包括熟悉，悠久的历史和子宫胎盘血管收缩的倾向低。然而，麻黄碱的疗效有限，难以滴定，引起产妇心动过速并抑制胎儿的pH和碱过多。去氧肾上腺素的优势包括高效，易于滴定以及使用大剂量将孕妇的血压维持在正常水平，然后防止恶心和呕吐而不会引起胎儿酸中毒的能力。然而，去氧肾上腺素可能会降低孕产妇的心率和心输出量，在高危情况下使用苯肾上腺素的数据很少。脱氧肾上腺素输注和快速晶体水化结合是描述的第一种可靠预防低血压的方法。总结：当考虑到当前证据时，作者认为，去氧肾上腺素是最接近满足产科最佳升压药标准的升压药。

著录项

相似文献

  • 外文文献
  • 中文文献
  • 专利
获取原文

客服邮箱：kefu@zhangqiaokeyan.com

京公网安备：11010802029741号 ICP备案号：京ICP备15016152号-6 六维联合信息科技 (北京) 有限公司©版权所有

  • 客服微信

  • 服务号