Application of different anesthesia methods in cesarean section of pregnant women with heart failure

Abstract

Objective To observe the application effects of different anesthesia methods in cesarean section of pregnant women with heart failure. Methods Fifty-one pregnant women with heart failure were selected from the Third People's Hospital of Puyang from August 2016 to January 2018. They were divided into general anesthesia group (17 cases), epidural anesthesia group (17 cases) and combined spinal-epidural anesthesia group (17 cases). The general anesthesia group received general anesthesia, the epidural anesthesia group received epidural anesthesia, and the combined spinal-epidural anesthesia group received combined spinal-epidural anesthesia. The changes of blood oxygen saturation (SpO2), improvement of heart failure symptoms and survival of pregnant women and fetuses were observed. Results In general anesthesia group, SpO2 increased to about 86% during operation, fetuses survived, and 6 parturients entered the intensive care unit after operation. In hard anesthesia group, no restlessness occurred during skin incision and fetal delivery, the symptoms of heart failure improved significantly after fetal delivery, and both parturients and fetuses survived. In 2 cases, local anesthesia was added to complete the operation due to poor blocking effect, but the symptoms of heart failure did not improve significantly during operation, and SpO2 increased as high as 92%. There were 3 cases of abrupt drop of blood pressure after anesthesia. Anesthesia was successful in combined spinal-epidural anesthesia group, the symptoms of fetal heart failure improved significantly after delivery, SpO2 increased to about 98%, and both parturients and fetuses survived. Conclusion The combined spinal-epidural anesthesia has a good blocking effect and can be used as the preferred anesthesia method for cesarean section in patients with pregnancy complicated with heart failure. Key words: Anesthesia; Pregnancy; Heart failure; Cesarean section