Effects of sevoflurane or propofol combined with remifentanil anesthesia on clinical efficacy and stress response in pregnant women with pregnancy-induced hypertension.

Abstract

To compare the effects of sevoflurane or propofol combined with remifentanil anesthesia on the clinical efficacy and stress response of pregnancy-induced hypertension (PIHS) in cesarean section. 150 patients with PIHS and treated with cesarean section in our hospital from May 2015 to September 2016 were selected. All patients were randomly divided into sevoflurane-remifentanil group (n=75) and propofol-remifentanil (n=75). The elbow blood of patients in both groups were collected, the levels of Norepinephrine (NE) adrenaline (AD), cortisol and blood glucose in plasma were compared at before anesthesia induction (T0), operation 30 min (T1), end of operation (T2), 2 h after operation (T3), 24 h after operation (T4). The blood pressure control, muscle control, anesthesia onset time, maternal pain and complications were compared between the two groups. The patients in the sevoflurane group were superior to the propofol group (p<0.05) in terms of muscle control effect, anesthesia onset time and maternal pain. There was no significant difference between the two groups in terms of blood pressure control and anesthesia complications (p>0.05). There was no significant difference in plasma AD, NE, cortisol and blood glucose between the two groups before induction of anesthesia (p>0.05). However, the plasma markers of the two groups began to increase after anesthesia induction and reached peak at T2 or T3, returned back to preoperative level or higher than before surgery at T4. The levels of AD, NE, cortisol and blood glucose in plasma of sevoflurane group were significantly lower than those in propofol group at T1-T4 time point, the difference was statistically significant (p<0.05). The clinical efficacy of sevoflurane combined with remifentanil anesthesia is better than that of propofol combined with remifentanil, and it can effectively reduce the stress of pregnant women with pregnancy-induced hypertension treated with cesarean section.