麻黄碱与去氧肾上腺素对胎心率的影响

目的比较麻黄碱与去氧肾上腺素对胎心率的影响。方法择期脊麻下行剖宫产手术的单胎足月妊娠产妇60例均分为两组。Ⅰ组泵注麻黄碱(4mg/ml);Ⅱ组泵注去氧肾上腺素(50μg/ml),调整药物输注速度维持血压接近术前基础值。监测胎儿娩出前胎心率(FHR)和产妇的血压(MAP)、心率(HR)。结果Ⅰ组发生胎儿心动过速18例(60.0%),明显多于Ⅱ组的3例(10.0%)(P<0.05);Ⅰ组产妇术中低血压、高血压和恶心呕吐的发生率高于Ⅱ组(P<0.05)。结论去氧肾上腺素可快速有效地纠正产妇低血压,但不会引起胎心率增快。

Effect of ephedrine and phenylephrine on fetal heart rate

Objective To compare the effect of equivalent ephedrine and phenylephrine on fetal heart rate.Methods Sixty mature parturient women with single-embryo scheduled for selective Cesarean section under spinal anesthesia were equally randomized into two groups of A(infusion of ephedrine 4 mg/ml) and B(infusion of phenylephrine 50 μg/ml).The maternal blood pressure was maintained at the level of near baseline by adjusting the infusion rate during anesthesia.The fetal heart rate and maternal BP and HR were recorded before fetal delivery.Results Fetal tachycardia in group A occurred in 18(60.0%) cases,which was higher than 3(10.0%) cases in group B(P<0.05).The incidence rates of hypotension or hypertension,nausea and vomiting were higher in group A than those in group B(P<0.05).Conclusion Phenylephrine can effectively and quickly correct maternal hypotension induced by spinal anesthesia without an increase of fetal heart rate.