The Effects Of Equivalent Doses With Different Vasopressors For Maternal And Neonatal In Caesarean Section

Objective:By comparing the equivalent doses of ephedrine and phenylephrine for cesarean section under CSEA, to observe the prevention and treatment of hypotension, the maternal side effects and the different effects on the newborns.Methods:40 patients undergoing elective cesarean section were randomly divided into two groups, continuous intravenous injection of small doses of ephedrine 8mg or phenylephrine 100μg were taken to prevent and treat hypotension of caesarean section under CSEA. It was to evaluate the newborns' Apgar score and NABA score through recording blood pressure, heart rate, maternal nausea, vomiting adverse reaction and measuring blood gases of umbilical artery and umbilical vein, lactate and glucose concentrations.Results:40 elective cesarean section patients under CSEA were randomly divided into two groups. Maternal general characteristics were presented in Table 1. The basic hemodynamic data including blood pressure, heart rate were shown in Table 2 and 3. Two groups of maternal age, height, weight, basic hemodynamic data were compared, no difference in the results. After undergoing CSEA, the maternal hemodynamic data has been recorded for 30 minutes, blood pressure and heart rate shown in Figure 4,5. Heart rate in both groups had no significant difference at any point in time. After intrathecal injection of 10min,15min,20min, maternal systolic blood pressure in P group was slightly lower than that in E group (P<0.05).Two maternal nausea cases (10%) occurred in each group. None of the maternal vomiting occurred. There was no difference in maternal side effects between P group and E group, see table 12. Infusion valumes of the two groups were shown in Table 6, no difference in infusion valumes for two groups. The times of patients administration for the two groups were presented in Table 9, the times of patients administration in P group was significantly higher than that in E group (P<0.01).Two groups of blood gas of fetal umbilical artery and umbilical vein were compared, see Table 7. The values of blood gas of umbilical artery in both groups were lower 7.2, however, the PH values of umbilical vein in E group were slightly lower than those in P group (P<0.05). The comparison of two groups of fetal lactate, glucose concentration was shown in Table 8, the values of lactate, glucose concentration in E group were higher than those in P group (P <0.05).The neonatal Apgar scores were recorded in the table 10 which showed the comparison of neonatal Apgar score of the two groups of newborns after birth lmin and 5min. None of newborn Apgar score was less than 8 in both groups, and no neonatal endotracheal intubation treatment or neonatal ICU treatment occurred. Newborn NABA scores were recorded in Table 11, which showed the behavior neurological test scores of newborns in 2h,24h and 48h, the results were similar. With time forward, the behavior neurological scores of the two group newborns were improved and could almost reach full score in 48h.Conclusion:Compared with ephedrine, phenylephrine is more efficient in the prevention and treatment of maternal hypotension after CSEA and will not cause fetal acidosis. Therefore, phenylephrine can be used as a first-line vasopressor in elective cesarean section under CSEA.