Comparative Study Hemodynamic Undergoing Caesarean Section By Combined Spinal-epidural Anesthesia And Continuous Epidural Blockade

Objective:To obsever hemodynamic effects undergoing caesarean section by combined spinal-epidural anesthesia and continuous epidural blockade,to study caesarean section on the hemodynamic effects the minimum anaesthesia, To research and improve the anesthesia management of cesarean deliver and to provide references for clinical to ensure the maternal and child safety.Methods:Eighty puerpera with cesarean deliver’ were randomly assigned to receive com-bined spinal-epidural anesthesia (CSEA group) or epidural anesthesia (CEA group)with40cases in each group. Before on T1(anesthesia)、T2(anesthesia plane satisfied-disinfection before)、T3(fetal childbirth)、 T4(10min in fetal childbirth)、T5(end) operation monitoring of two groups of cesarean section patients perioperative 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 CEA group at T4(10min 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 CEA group at T3(child birth)(P=0.000,0.000).Mean arterial pressure(MAP) was higher in CSEA group than in CEA 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 CEA group(P=0.000).There were differences in neonatal Angar score,complications and adverse reactions between two groups(P>0.05). Conclusion:CEA and CSEA are both suitable anesthesia for the puerpera with cesarean deliver. However, CSEA is more recommended for its faster onset, better anesthetic effect and little effect on maternal hemodynamics.