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11 results on '"Wei, Chang-na"'

5. The Median Effective Dose of Oxytocin Needed to Prevent Uterine Atony During Cesarean Delivery in Elderly Parturients

Author

Wei, Chang Na, Deng, Jia Li, Dong, Jin Hua, Ping, Ze Peng, and Chen, Xin Zhong

Subjects
Adult, Drug Design, Development and Therapy, Adolescent, Dose-Response Relationship, Drug, Cesarean Section, postpartum haemorrhage prevention, Middle Aged, Oxytocin, Anesthesia, Spinal, Young Adult, bolus, maternal age, Pregnancy, Oxytocics, drug delivery, Injections, Intravenous, Humans, Female, Uterine Inertia, Original Research
Abstract

Chang Na Wei,1,2,* Jia Li Deng,1,2,* Jin Hua Dong,3 Ze Peng Ping,3 Xin Zhong Chen1,2 1Department of Anesthesia, Women’s Hospital, Zhejiang University School of Medicine, Hangzhou 310006, People’s Republic of China; 2Department of Anesthesia, Jiaxing University Affiliated Women and Children Hospital, Jiaxing 314000, People’s Republic of China; 3Department of Obstetrics, Jiaxing University Affiliated Women and Children Hospital, Jiaxing 314000, People’s Republic of China*These authors contributed equally to this workCorrespondence: Xin Zhong ChenDepartment of Anesthesia, Women’s Hospital, Zhejiang University School of Medicine, Xueshi Road 1, Hangzhou 310006, People’s Republic of ChinaTel +86 13575738058Email chenxinz@zju.edu.cnPurpose: Oxytocin is the first-line agent to prevent and treat uterine atony during cesarean delivery (CD). We compared the effective dose in 50% of the parturients (ED50) of a prophylactic oxytocin bolus during CD in young (< 35 years) and old parturients (≥ 35 years) using Dixon’s up-and-down method.Patients and Methods: Twenty-eight young parturients (young group) and 25 old parturients (old group) undergoing CD under combined spinal-epidural anesthesia were enrolled. The initial oxytocin bolus was 0.5 IU, with increments or decrements of 0.25 IU. Maternal adverse effects, requirement for additional uterotonic agents, and estimated blood loss were recorded.Results: The ED50 for oxytocin in the old group was higher than that in the young group (1.41 IU; 95% confidence interval, 0.63– 2.19) vs 0.66 IU (0.04– 1.29), P < 0.001). The total oxytocin dose in the old group was higher than in the young group (5.9 ± 2.9 vs 4.1 ± 2.1 IU, P = 0.01). The estimated blood loss in the older group and young group was 401.2 ± 204.5 mL and 289.3 ± 104.6 mL, respectively (P =0.01). The overall prevalence of adverse effects was higher in the old group than in the young group (68.0% vs 21.4%, P < 0.001).Conclusion: The initial bolus and total requirement of oxytocin for preventing uterine atony were higher in old parturients than in young parturients during CD. Advanced maternal age may necessitate higher doses of oxytocin.Keywords: maternal age, drug delivery, bolus, postpartum haemorrhage prevention

Published
2020

11. Abdominal girth and vertebral column length can adjust spinal anesthesia for lower limb surgery, a prospective, observational study.

Author

Zhou QH, Zhu B, Wei CN, and Yan M

Subjects
Abdominal Fat drug effects, Abdominal Fat metabolism, Adult, Female, Humans, Injections, Spinal, Male, Middle Aged, Prospective Studies, Spine metabolism, Waist Circumference physiology, Anesthesia, Spinal methods, Anesthetics, Local administration & dosage, Bupivacaine administration & dosage, Lower Extremity surgery, Spine drug effects, Waist Circumference drug effects
Abstract

Background: Studies have shown that abdominal girth and vertebral column length have high predictive value for spinal spread after administering a dose of plain bupivacaine. we designed a study to identify the specific correlations between abdominal girth, vertebral column length and a 0.5% dosage of plain bupivacaine, which should provide a minimum upper block level (T12) and a suitable upper block level (T10) for lower limb surgeries., Methods: A suitable dose of 0.5% plain bupivacaine was administered intrathecally between the L3 and L4 vertebrae for lower limb surgeries. If the upper cephalad spread of the patient by loss of pinprick discrimination was T12 or T10, the patient was enrolled in this study. Five patient variables and intrathecal plain bupivacaine dose were recorded. Linear regression and multiple regression analyses were performed., Results: Totals of 111 patients and 121 patients who lost pinprick discrimination at T12 and T10, respectively, were analyzed in this study. Linear regression analysis showed that only abdominal girth and plain bupivacaine dose were strongly correlated (r =-0.827 for T12, r = -0.806 for T10; both p < 0.0001). Multiple linear regression analysis showed that both abdominal girth and vertebral column length were the key determinants of plain bupivacaine dose (both p < 0.0001). R(2) was 0.874 and 0.860 for the loss of pinprick discrimination at T12 and T10, respectively., Conclusions: Our data indicated that vertebral column length and abdominal girth were strongly correlated with the dosage of intrathecal plain bupivacaine for the loss of pinprick discrimination at T12 and T10. The two regression equations were YT12 = 3.547 + 0.045X1-0.044X2 and YT10 = 3.848 + 0.047X1- 0.046X2 (Y, 0.5% plain bupivacaine volume; X1, vertebral column length;and X 2, abdominal girth), which can accurately predict the minimum and suitable intrathecal bupivacaine dose for lower limb surgery to a great extent, separately.

Published
2016
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