Observation Of The Effect Of Phenylephrine And Norepinephrine On Hypotension After Combined Spinal Epidural Anesthesia In Cesarean Section

Objective: To investigate phenylephrine and norepinephrine to correct hypotension after combined spinal epidural anesthesia effect,providing a theoretical basis for obstetric anesthesiamanagement.Methods:Pregant women with maternal hypotension after spinal epidural for cesarean section were includedwho wereASA I-II,preoperative normal fetal heart rate,no circulation system,respiratory system,blood system,endocrine system and kidney disease,pregnancy no complications of spinal anesthesia contraindications.Pregnant women were randomly divided into two groups: control group,40 cases(phenylephrine group,P group)and 40 cases in experimental group(norepinephrine group,N group).The routine combined spinal epidural anesthesia and subarachnoid injection within 15 seconds of 0.5% hyperbaric bupivacaine 3ml(0.75% levobupivacaine 2ml with 10% Glucose Injection 1ml),the two groups of pregnant women in supine position,when the systolic pressure of less than 90 mmHg or compared with the basic value of less than 20%,group P intravenous injection of phenylephrine 50 ~ 100 ug,group N intravenous injection of noradrenaline 5 ~ 10 ug,respectively.A stable base record blood pressure(T0),lowedblood pressureafteranesthesia(T1),5minafter administrationvasopressor(T2),10 min after administrationvasopressor(T3),beginning of the operation(T4),cesarean section(T5),the fetus removed(T6),5min after removal of the fetus(T7),10 min after removal of the fetus(T8),the end of operation(T9).Systolic blood pressure(SBP),diastolic blood pressure(DBP),mean arterial pressure(MAP),heart rate(HR),pulse oxygen saturation(SpO ?)were recorded.Bradycardia,nausea,vomiting inpregnant women,umbilical artery blood gas and neonatal Apgar scorein 1 minute,5 minute s were alsorecorded.Results: Bradycardia and nauseawere no significant different between two groups,but vomiting rate in group Pwasgreater than group N.Apgar scorein1 minute,5 minutes andumbilical arteryblood gas analysis were no significant differentbtween two groups.Hemodynamics parameterswere similar in the eachmonitoring points between two groups of pregnant women.Conclusion: Intermittent intravenous infusion of phenylephrine or intravenous infusion of norepinephrine could treat maternal hypotension in pregnancy women caused by combined spinal epidural anesthesia and is safe and effective for pregnancy women and infant.