Influence of combined spinal epidural anesthesia with head-up of 10°on maternal hemodynamics during cesarean section
Hongchun Shen, Lijun Gao, Li Cai
Published 2016-10-01
Cite as Chin J Prim Med Pharm, 2016, 23(19): 2988-2992. DOI: 10.3760/cma.j.issn.1008-6706.2016.19.028
Abstract
ObjectiveTo explore the anesthesia effect and influence of combined spinal epidural anesthesia(CSEA) with head-up of 10°on maternal hemodynamics during cesarean section.
Methods120 pregnant women undergoing cesarean section were selected, and were randomly divided into group A, B and C, 40 cases in each group.Three groups were all given CSEA, yet pregnant women in group A were taken supine position, group B was taken head-up of 10°, and group C was taken head-up of 20°.Hemodynamic parameters of three groups of the following time points were compared, including before anesthesia(T0), 5min after anesthesia(T1), skin incision(T2), fetal disengagement immediately(T3), and operation at the end(T4), also anesthesia effect was recorded, and usage of ephedrine and local anesthetic was noted, and adverse reactions were compared.
ResultsCompared with T0, group A's hemodynamics in T1 decreased, including systolic blood pressure (SBP), diastolic blood pressure (DBP), and increased in T2 and T3, yet there were no statistical differences on hemodynamics in three groups in T4.Compared with group B and C, there were statistical differences on hemodynamics in T1, T2 and T3 in group A(t=3.63-7.25, P<0.05 or P<0.01), yet there were no statistical differences on hemodynamics in group B and C(t=0.00-0.93, all P>0.05). Anesthesia block scores in group A, B and C were (2.0±0.3)points, (2.5±0.2) points, (2.6±0.2) points, and scores of B and C were higher than that in group A(t=3.92, 4.01, all P<0.05). Cases and total usage of ephedrine in group A were higher than those of group B and C(χ2=31.43, 50.61, t=16.27, 20.17, all P<0.01). Cases of adjusting surgical position, and addition of local anesthetic in group C were significantly higher than those of group B(χ2=23.85, 28.47, all P<0.01).
ConclusionIt has better anesthetic effect of taking CSEA by head-up of 10°, and maternal hemodynamics are more stable, can better meet operation's requirements, also with easier operation, so it is superior to supine position and head-up of 20°.
Key words:
Cesarean section; Hemodynamics; Combined spinal epidural anesthesia; Body position
Contributor Information
Hongchun Shen
Department of Anesthesia, Maternal and Child Healthcare Hospital of Cixi, Cixi, Zhejiang 315300, China
Lijun Gao
Department of Anesthesia, Maternal and Child Healthcare Hospital of Cixi, Cixi, Zhejiang 315300, China
Li Cai
Department of Anesthesia, Maternal and Child Healthcare Hospital of Cixi, Cixi, Zhejiang 315300, China
