Analysis of influence of anesthetic effect, maternal and infant outcomes and safety of subarachnoid block using sulfentanyl combined with ropivacaine for patients with gestational hypertension in the cesarean section

Abstract

Objective To study the influence of anesthetic effect, maternal and infant outcomes and safety of subarachnoid block used sulfentanyl combined with ropivacaine for patients with gestational hypertension in the cesarean section. Methods 180 cases of gestational hypertension ready to cesarean section were selected as study subjects, and they were randomly divided into A group, B group and C group by digital table method, 60 cases in each group.A group used 10mg ropivacaine, B group used 13mg ropivacaine, C group used 5μg sulfentanyl combined with 10mg ropivacaine.The anesthetic effect, circulation function, duration of pain, operation time, neonatal Apgar score at 1 and 5 min after birth, neonatal weight, motor block evaluation after operation, adverse reaction and complication were compared in three groups. Results The anesthetic effect between B group and C group had no statistical difference(χ2=1.233, 1.465, all P>0.05). The anesthetic effect of B group and C group was better than that of A group(F=5.633, 7.299, all P 0.05). Compared with T0, the HR and MAP of B group at T1, T2, T3, T4 had statistical differences compared with A group and C group(F=5.633, 7.299, all P 0.05). The duration of pain between B group and C group had no statistical difference(t=0.822, P>0.05). The duration of pain of A group was longer than that of B group and C group(F=8.316, P 0.05). The improved Bromage score between A group and C group had no statistical difference(t=2.627, 1.991, all P>0.05). The improved Bromage score between B group and A, C group had statistical differences(F=6.371, 5.693, all P<0.05). The complete recovery time of motor nerve of B group was much longer than that of A group and C group(F=8.924, P<0.05). The incidence rates of vomit and nausea of A group and B group were much higher than that of C group(F=3.561, 12.581, all P<0.05). The incidence rate of bradycardia and hypotension of B group was much higher than that of A group and C group(F=8.273, 10.833, all P<0.05). Conclusion During subarachnoid block anaethesia using 5μg sulfentanyl combined with 10mg ropivacaine can be applied to mild and moderate gestational hypertension, it has advantages such as less adverse reaction, good analgesic effect, less hemodynamic effect, and it is worthy of clinical promotion. Key words: Hypertension, Pregnancy-Induced; Sulfentanyl; Ropivavaine; Subarachnoid Space; Nerve Block