Influence of combined spinal epidural anesthesia with head-up of 10°on maternal hemodynamics during cesarean section

Abstract

Objective To explore the anesthesia effect and influence of combined spinal epidural anesthesia(CSEA) with head-up of 10°on maternal hemodynamics during cesarean section. Methods 120 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. Results Compared 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). 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). Conclusion It 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