Comparative study of effects of combined spinal-epidural anesthesia and epidural anesthesia on haemodynamics in the puerpera with cesarean delivery

Abstract:

Objective：To research and improve the anesthesia management of cesarean delivery and to provide references for clinical to ensure the maternal and child safety. Methods：Eighty puerpera with cesarean delivery were randomly assigned to receive com－bined spinal-epidural anesthesia（CSEA group） or epidural anesthesia（EA group） with 40 cases in each group. Homodynamic changes，anesthetic effect，neonatal Apgar score，complications and adverse reactions were measured in the two groups. Results：Heart rate（HR） of puerpera was higher in CSEA group than in EA group at T4（10 min after child birth）and T5（operation finish）（P=0.023，0.022）. Systolic blood pressure（SBP） and diastolic blood pressure（DBP） were higher in CSEA group than in EA group at T3 （child birth）（P=0.000，0.000）. Mean arterial pressure（MAP） was higher in CSEA group than in EA group at T2（satisfied anesthesia-before disinfection）and T5（operation finish）（P=0.000，0.003）. There was no differences in cardiac output（CO），stroke volume（SV），systemic vascular resistance（SVR） and thoracic fluid content（TFC） between two groups at different time points（all P >0.05）.There were differences in HR，SBP，DBP，MAP，CO，SV and SVR within each group at different time points（P<0.05）. Anesthetic effect of CSEA group was better than that of EA group（P=0.000）. There were differences in neonatal Apgar score，complications and adverse reactions between two groups（P >0.05）. Conclusion：EA and CSEA are both suitable anesthesia for the puerpera with cesarean de－livery. However，CSEA is more recommended for its faster onset，better anesthetic effect and little effect on maternal hemodynamics.