Effect of Immediate Dilation of Phenylephrine and Hydroxyethyl Starch on Maternal Hemodynamics and Fetal pH Value During Cesarean Section Under Combined Spinal Epidural Anesthesia
TIAN Hang, et al
Guangzhou Women and Children Health Care Center, Guangdong Guangzhou 510623, China
Abstract：Objective: To explore the effect of maternal hemodynamics and fetal acid-base values of immediate expansion of hydroxyethyl starch and phenylephrine hydrochloride on combined spinal-epidural analgesia. Methods: According to the different ways of dealing with hypotension,51 cases of elective cesarean section under combined spinal-epidural analgesia were divided into two groups: Phenylephrine hydrochloride group (group P) and Hydroxyethyl starch immediate expansion group (group C). Mean arterial pressure, heart rate, standard volume of output and cardiac output (CO) at the time of anesthesia and post anesthesia between the two groups were compared. The blood gas results of umbilical vein blood of the two groups were compared. Apgar scores at 1 min and 5 min after delivery, and the time from anesthesia to neonatal delivery (IDI) of the two groups were compared. Results: There was no significantly difference of mean arterial pressure, cardiac output and cardiac output between the two groups (P> 0.05). The heart rate of the two groups were increased and then decreased, then increased. The heart rate of group C was significantly lower than that of group P at T2, T3, T4, T5, T6, T7 and T8 (P <0.05). The levels of pH, PO2, PCO2 and HCO3 in the umbilical vein blood of the two groups were all within the normal range, there was no significantly difference between the two groups (P>0.05). The duration of cesarean section, and Aparg score at 1 minute and 5 minutes after umbilical cord cut short were no significantly difference (P> 0.05). Conclusion: Combined spinal-epidural analgesia with hydroxyethyl starch immediate expansion can obviously reduce the hypotension at elective cesarean section; deoxidation adrenaline can maintain the maternal systemic stability, and does not increase heart work, little influence on newborn blood gas analysis
田航, 李新宇, 程秋菊, 刘文兴, 宋兴荣. 腰硬联合麻醉下剖宫产术中去氧肾上腺素与羟乙基淀粉即时扩容对产妇血流动力学及胎儿酸碱值的影响[J]. 河北医学, 2017, 23(4): 572-575.
TIAN Hang, et al. Effect of Immediate Dilation of Phenylephrine and Hydroxyethyl Starch on Maternal Hemodynamics and Fetal pH Value During Cesarean Section Under Combined Spinal Epidural Anesthesia. 河北医学, 2017, 23(4): 572-575.
[1] Meltzer EO, Ratner PH, McGraw T. Phenylephrine hydrochloride modified-release tablets for nasal congestion: a randomized, placebo-controlled trial in allergic rhinitis patients[J].Ann Allergy Asthma Immunol,2016,116(1):66~71. [2] Martin-Flores M, Mercure-McKenzie TM, Campoy L, et al. Controlled retrospective study of the effects of eyedrops containing phenylephrine hydrochloride and scopolamine hydrobromide on mean arterial blood pressure in anesthetized dogs[J].Am Vet Res,2010,71(12):1407~1412. [3] Gosliga JM, Barter LS. Cardiovascular effects of dopamine hydrochloride and phenylephrine hydrochloride in healthy isoflurane-anesthetized New Zealand White rabbits (Oryctolagus cuniculus)[J].Am Vet Res,2015,76(2):116~121. [4] McDonald S, Fernando R, Ashpole K, et al. Maternal cardiac output changes after crystalloid or colloid coload following spinal anesthesia for elective cesarean delivery: a randomized controlled trial[J].Anesth Analg,2011,113(4):803~810. [5] 郭新春,陈清梅,谭兴权,等.6%羟乙基淀粉(130/0.4)扩容治疗对腰硬联合麻醉下剖宫产产妇低血压的预防效果[J].实用心脑肺血管病杂志,2015,(05):141~142+145. [6] 顾彩萍. 不同体位对剖宫产术中产妇低血压综合征发生的影响[J].中国乡村医药,2012,(16):30~31.
2017, Vol. 23 
冀公网安备13080202000677号