Abstract
Objective The purpose of the study was to investigate the effect of combined spinal-epidural anesthesia (CSEA) and total intravenous anesthesia (TIVA) on hemodynamics and pregnancy outcomes of severe preeclampsia pregnant patients undergoing cesarean section. Methods 126 patients with severe preeclampsia admitted to Zhangqiu District People's Hospital from August 2018 to August 2019 were selected as the study subjects and randomly divided into the experimental group (n = 63) and control group (n = 63). After undergoing cesarean section, the patients in the experimental group received CSEA, while those in the control group were given TIVA. After that, the effect of different anesthesia methods on the hemodynamics and pregnancy outcomes of pregnant women was compared. Results There were no significant differences in age, BMI value, weight, height, gestational weeks, SBP, DBP, and residence between the two groups (P > 0.05). The operation duration, the onset time of anesthesia, and delivery time in the experimental group were significantly shorter than those in the control group, with less intraoperative blood loss in the experimental group than that in the control group (P < 0.001). In both groups, MAP and SpO2 during delivery were significantly lower than those before anesthesia, and HR was significantly higher than that before anesthesia (P < 0.001). In the experimental group, MAP and HR during delivery were significantly lower than those in the control group, and SpO2 was significantly higher than that in the control group (P < 0.001). The total effective rate of anesthesia in the experimental group was significantly higher than that in the control group (P < 0.05). The Apgar scoring of the newborns in the experimental group was significantly higher than that in the control group (P < 0.001), and the total incidence of postoperative adverse reactions in the experimental group was significantly lower than that in the control group (P < 0.05). Conclusion CSEA is a reliable anesthesia method for improving the hemodynamics indicators in pregnant patients with severe preeclampsia; such strategy greatly increases the Apgar score of newborns and shortens the anesthesia onset time. Further research will be conducive to establishing a better anesthesia plan for such patients.
Highlights
Preeclampsia, a common pregnancy complication mostly occurring after 20 weeks of gestation, is mainly manifested by elevated blood pressure and proteinuria
With the progress of the disease, severe preeclampsia will further develop into eclampsia, which results in convulsions or coma of puerperae and induces some complications such as heart failure, retinal detachment, and placental abruption, seriously threatening maternal and infant health [1, 2]. e latest data from the World Health Organization showed that the incidence of severe preeclampsia was 3.2–5% and the death rate was 4.3–5.6% [3]
combined spinal-epidural anesthesia (CSEA) has the advantages of the rapid onset time, good blocking effect, and obvious analgesic effect, which have been proven in patients with pregnancyinduced hypertension syndrome undergoing cesarean section [4]
Summary
Preeclampsia, a common pregnancy complication mostly occurring after 20 weeks of gestation, is mainly manifested by elevated blood pressure and proteinuria. Cesarean section is a common treatment for severe preeclampsia, and the selection of anesthesia methods has become the research focus of current medical community. Different anesthesia methods bring different effects to pregnant women and pregnancy outcomes [6]. There are few reports exploring the application of CSEA and TIVA in severe preeclampsia pregnant patients undergoing cesarean section. In this study, with the purpose of further exploring the effect of CSEA and TIVA on hemodynamics and pregnancy outcomes of severe preeclampsia pregnant patients undergoing cesarean section, 126 pregnant patients with severe preeclampsia admitted to Zhangqiu District People’s Hospital from August 2018 to August 2019 were selected as the study subjects, and the summary report is as follows
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