2013年1月3日木曜日

130103 晶質液pre-load 


帝王切開の脊髄クモ膜下麻酔の低血圧予防

よくまとまってる!!

Can J Anaesth. 2012;59:604-19.
Fluid and vasopressor management for Cesarean delivery under spinal anesthesia: continuing professional development.
Loubert C.
http://link.springer.com/article/10.1007%2Fs12630-012-9705-9

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20ml/kgの晶質液pre-loadで低血圧の発現に差がなかった(55% vs コントロール71%)

Anesthesiology. 1993;79:262-9.
A reevaluation of the role of crystalloid preload in the prevention of hypotension associated with spinal anesthesia for elective cesarean section.
Rout CC, Rocke DA, Levin J, Gouws E, Reddy D.



30 mLkg-1 までの晶質液pre-load投与では低血圧を予防できず、児の予後にも影響を与えなかった。
Anesth Analg. 1996;83:299-303.
The effects of varying volumes of crystalloid administration before cesarean delivery on maternal hemodynamics and colloid osmotic pressure.
Park GE, Hauch MA, Curlin F, Datta S, Bader AM.


Morgan PJ, Halpern SH, Tarshis J.
The effects of an increase of central blood volume before spinal anesthesia for cesarean delivery: a qualitative systematic review.
Anesth Analg 2001; 92: 997-1005.


現在では晶質液pre-loadは低血圧予防に有効とはいえない。
Mercier FJ. (物静かなイケメン、日本にも来られました)
Fluid loading for cesarean delivery under spinal anesthesia: have we studied all the options?
Anesth Analg 2011; 113: 677-80.

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