Effect Of Preload Different Kinds Of Liquid Combined With Phenylephrine On Parturient And Neonate During Epidural Anesthesia For Cesarean Section

Objective:To investigate the effect of preload different kinds of liquid combined with phenylephrine on Parturients and neonate during epidural anesthesia for cesarean section.Methods:Sixty patients who were eligible to cesarean section were randomly divided into two groups:hydroxyethyl starch（6%in normal saline）500 mL（group H）and Lactated Ringer’s solution 1000 m L（group R）,30 cases in each group.All patients were treated with a phenylephrine infusion 0.5μg·kg^-1·min^-1.Phenylephrine infusion protocol was continued until the time of fetal extraction.Recorded the anesthesia（T₀）,3min（T₁）,10 min（T₂）,delivery the fetus of 3 min（T₃）、10 min（T₄）the HR,SBP and DBP before and after cesarean section;The perioperative adverse events of parturients and the amount of bleeding with in 24 hours after surgery and the first time to flatus and the Apgar score of the newborn at 1,5 min were recorded;At the same time,umbilical vein blood gas analysis results of the fetus after delivery was also recorded.Results:compared with group R,group H at T₄ HR was decreased,compared with group H,group R at T₂ SBP decreased significantly,group R at T₄ DBP was decreased（P<0.05）.HR in group H decreased T₁,T₂,T₄ but not in the group R,SBP in group H decreased T₂and group R decreased T₂,T₄.DBP in group H decreased T₁^T₄ and group R decreased T₂^T₄.The amount of bleeding 24 hours after delivery there was no significant difference between the two groups（P>0.05）.and the time to first exhaust in group R was significantly later than that in group H（P<0.05）;no significant difference between the two groups of nausea,vomiting and chest tightness,there was no significant difference between the two groups（P>0.05）.Group R of fetal umbilical venous blood lactate was significantly higher than H group（P<0.05）,group H of fetal umbilical vein blood glucose and the value of actual bicarbonate was higher than that of R group（P<0.05）;no significant difference in the 1 min and 5 min Apgar values of newborns between two groups（P>0.05）.Conclusions:The preload with 6%of hydroxyethyl starch before cesarean section was beneficial for the more stable hemodynamics and can promote postoperative gastrointestinal function recovery and reduce the amount of postoperative bleeding.