目的研究程控硬膜外间歇脉冲注入(PIEB)对分娩疼痛、产间发热及分娩结局的影响。方法前瞻性选择2021年7月至2022年6月沧州市人民医院收治的初产妇200例,依据随机数字表法分为实验组(n=100)与对照组(n=100)。对照组行持续硬膜外输注(CEI...目的研究程控硬膜外间歇脉冲注入(PIEB)对分娩疼痛、产间发热及分娩结局的影响。方法前瞻性选择2021年7月至2022年6月沧州市人民医院收治的初产妇200例,依据随机数字表法分为实验组(n=100)与对照组(n=100)。对照组行持续硬膜外输注(CEI)镇痛,实验组行PIEB镇痛。记录并比较两组镇痛前(t_(0))、镇痛后1 h(t_(1))、2 h(t_(2))及宫口开全时(t_(3))的疼痛情况;整个产程中两组罗哌卡因、舒芬太尼用量;镇痛前(t_(0))、胎儿娩出即刻(t_(4))及分娩后2 h(t_(5))白细胞介素(IL)-1β、IL-6及肿瘤坏死因子-α(TNF-α)等炎症因子水平及鼓膜温度;各产程时间、产后出血、器械助产、会阴侧切等分娩情况;新生儿1、5 min Apgar评分。结果t_(0)、t_(1)时,两组VAS评分比较,差异均无统计学意义(P>0.05);t_(2)、t_(3)时,实验组VAS评分均小于对照组,差异均有统计学意义(P<0.05)。实验组罗哌卡因、舒芬太尼用量均小于对照组,差异均有统计学意义(P<0.05)。t_(4)、t_(5)时,两组血清IL-1β、IL-6、TNF-α水平及鼓膜温度均高于t_(0),且实验组血清IL-1β、IL-6、TNF-α水平及鼓膜温度均低于对照组,差异均有统计学意义(P<0.05)。两组第一产程时间、新生儿1 min Apgar评分、新生儿5 min Apgar评分、产后出血、会阴侧切及器械助产情况比较,差异均无统计学意义(P>0.05);实验组第二、第三产程时间均小于对照组,差异均有统计学意义(P<0.05)。结论与CEI镇痛相比较,PIEB镇痛产妇胎儿娩出即刻及分娩后疼痛程度轻,血清炎症因子水平低,麻醉药物用量少,分娩结局良好。展开更多
Published clinical data of Prazosin were reevaluated pharmacokinetically using explicit solutions to drug concentration as a function of total time for IV bolus injection, intermittent intravenous infusion and oral ro...Published clinical data of Prazosin were reevaluated pharmacokinetically using explicit solutions to drug concentration as a function of total time for IV bolus injection, intermittent intravenous infusion and oral routes of administration in an open two-compartment model. In a novel way, the apparent volume of distribution was estimated from a two-compartment model and found to be close to the total body water suggesting that Prazosin is distributed in all tissues both extracellularly and intracellularly. In addition, extracting the value of the apparent volume of distribution from a two-compartment model allowed comparative simulations in the one-compartment model. It is shown that dosage calculations of Prazosin intermittent infusion can be safely performed using the simpler one-compartment model equations. Lastly, several additional time-dependent pharmacokinetic parameters e.g., the peak time in the central and peripheral compartment and non-steady state and steady state peak concentration and AUC were determined using series equations for all three routes of administration, as a function of dose number and total time upon multiple drug administrations in the two-compartment model. It is also the first time that steady-state plasma drug concentration equations were derived in a two-compartment mammillary model.展开更多
文摘目的研究程控硬膜外间歇脉冲注入(PIEB)对分娩疼痛、产间发热及分娩结局的影响。方法前瞻性选择2021年7月至2022年6月沧州市人民医院收治的初产妇200例,依据随机数字表法分为实验组(n=100)与对照组(n=100)。对照组行持续硬膜外输注(CEI)镇痛,实验组行PIEB镇痛。记录并比较两组镇痛前(t_(0))、镇痛后1 h(t_(1))、2 h(t_(2))及宫口开全时(t_(3))的疼痛情况;整个产程中两组罗哌卡因、舒芬太尼用量;镇痛前(t_(0))、胎儿娩出即刻(t_(4))及分娩后2 h(t_(5))白细胞介素(IL)-1β、IL-6及肿瘤坏死因子-α(TNF-α)等炎症因子水平及鼓膜温度;各产程时间、产后出血、器械助产、会阴侧切等分娩情况;新生儿1、5 min Apgar评分。结果t_(0)、t_(1)时,两组VAS评分比较,差异均无统计学意义(P>0.05);t_(2)、t_(3)时,实验组VAS评分均小于对照组,差异均有统计学意义(P<0.05)。实验组罗哌卡因、舒芬太尼用量均小于对照组,差异均有统计学意义(P<0.05)。t_(4)、t_(5)时,两组血清IL-1β、IL-6、TNF-α水平及鼓膜温度均高于t_(0),且实验组血清IL-1β、IL-6、TNF-α水平及鼓膜温度均低于对照组,差异均有统计学意义(P<0.05)。两组第一产程时间、新生儿1 min Apgar评分、新生儿5 min Apgar评分、产后出血、会阴侧切及器械助产情况比较,差异均无统计学意义(P>0.05);实验组第二、第三产程时间均小于对照组,差异均有统计学意义(P<0.05)。结论与CEI镇痛相比较,PIEB镇痛产妇胎儿娩出即刻及分娩后疼痛程度轻,血清炎症因子水平低,麻醉药物用量少,分娩结局良好。
文摘Published clinical data of Prazosin were reevaluated pharmacokinetically using explicit solutions to drug concentration as a function of total time for IV bolus injection, intermittent intravenous infusion and oral routes of administration in an open two-compartment model. In a novel way, the apparent volume of distribution was estimated from a two-compartment model and found to be close to the total body water suggesting that Prazosin is distributed in all tissues both extracellularly and intracellularly. In addition, extracting the value of the apparent volume of distribution from a two-compartment model allowed comparative simulations in the one-compartment model. It is shown that dosage calculations of Prazosin intermittent infusion can be safely performed using the simpler one-compartment model equations. Lastly, several additional time-dependent pharmacokinetic parameters e.g., the peak time in the central and peripheral compartment and non-steady state and steady state peak concentration and AUC were determined using series equations for all three routes of administration, as a function of dose number and total time upon multiple drug administrations in the two-compartment model. It is also the first time that steady-state plasma drug concentration equations were derived in a two-compartment mammillary model.
