Study On The Correlation Between The Optic Nerve Sheath Diameter Measured By Ultrasound And The Amount Of Ropivacaine In Cesarean Section Of Combined Spinal And Epidural Anesthesia

Objective: To study the correlation between the optic nerve sheath diameter and the amount of ropivacaine and the anesthesia plane in the cesarean section.Methods: Selected to 30 cases of maternal late pregnancy with ONSD ≥5.3mm and 30 cases of single-pregnancy late pregnancy with ONSD < 5.3 mm.(gestational weeks ≥ 28 weeks).The pregnant woman of ONSD≥5.3mm was divided into group A and group B and the pregnant women with ONSD <5.3mm were divided into group C and group D randomly,15 cases in each group(n=15).Group A and group C were low dose(12 mg)group of ropivacaine,and group B and group D were high dose(15 mg)of ropivacaine.ASA was grade I to III,age was 25 to 45 years old,were combined with lumbar and hard anesthesia in L3-4 interval,and the supine position was taken after anesthesia.General data such as age,body mass index(BMI)and gestational week of the four groups of pregnant women.Before pre-anesthesia(T0)and 15 minutes after anesthesia(T1)were recorded systolic blood pressure(SBP),diastolic blood pressure(DBP),mean arterial pressure(MAP),heart rate(HR),the optic nerve sheath diameter(ONSD)and total amount of ephedrine,anesthesia plane at T1,time of surgery,and other adverse reactions.The correlation between age,gestational age,BMI,ONSD,MAP and anesthesia plane diffusion was analyzed by multiple linear regression analysis.The data of normal distribution were expressed by mean and standard deviation.The paired samples were compared between the left and right side of the ONSD and the anesthesia before and after the anesthesia.One-way ANOVA was used between the three groups or above.The overall difference was repeated by the Post poc hoc Tukey method.The count data was used to compare the chi-square test.Results:1.There were no significant differences in the general conditions of maternal age,gestational week,and time of surgery(P>0.05).2.The dose of ropivacaine,BMI,ONSD before anesthesia,and post-anesthesia MAP were correlated with anesthesia plane(P<0.05),age,gestational age,ONSD after anesthesia,MAP before anesthesia,heart rate before and after anesthesia were not associated with anesthesia plane(P>0.05);3.Dosage with ropivacaine,ONSD before anesthesia,MAP after anesthesia The independent variable was multivariate linear regression multivariate analysis with the anesthesia plane as the dependent variable(F=16.669).The final regression equation was statistically significant(P<0.01).From the model point of view,ropivacaine dose,pre-anesthesia ONSD,post-anesthesia MAP were all factors affecting maternal anesthesia plane;4,four groups of maternal same subjects There was no significant difference in the diameter of the right and left optic nerve sheaths(P>0.05).5.Comparison of BMI index among the four groups:There was no significant difference in the BMI between the four groups(P>0.05).6.Comparison of the amount of ephedrine used in the four groups: the difference in the amount of ephedrine used in group A and group B and C Statistical significance(P<0.05);There was no significant difference in the amount of ephedrine between group A and group D(P>0.05).7.Comparison of maternal anesthesia planes in group4: 13 cases of subarachnoid block in group A It is T6,accounting for 86.7%;the highest retarding plane T4;the lowest retarding plane T10.In group B,6 cases of maternal subarachnoid block were T6,accounting for 40%;the highest block plane T2;the lowest block plane T8.In group C,9 cases of maternal subarachnoid block were T6,accounting for 60%;the highest block plane T4;the lowest block plane T12.In group D,12 cases of maternal subarachnoid block were T6,accounting for 80%;the highest block plane T2;the lowest block plane T6.There was significant difference between group A and group B(P<0.01).There was significant difference between group B and group D(P<0.05).8.Comparison of MAP between four groups of women before and after anesthesia: There was no statistical difference in MAP between the four groups at T0.The significance of learning(P>0.05);There was significant difference between group A and group B at T1(P<0.05);the difference between group A and group C and group D was statistically significant(P<0.01);group B and group C There was significant difference between the D group and the D group(P<0.01).There was significant difference between the C group and the D group(P<0.01).9.The comparison of the ONSD before and after the anesthesia of the four groups: Group A and B before anesthesia,C There was no significant difference between group and group D(P>0.05).There was significant difference between group A and group C and group D(P<0.01).There was significant difference between group B and group C and group D(P< 0.01).There was significant difference between group A and group B and group D at T1(P<0.05).There was significant difference between group A and group C(P<0.05).There was significant difference between group B and group D(P<0.05).10.Comparison of heart rate before and after anesthesia in four groups: There was no significant difference between group A and group B,group C and group D at time T0(P>0.05).There were statistical differences between group A and group C and group D.The significance of learning(P<0.05);the difference between group B and group C was statistically significant(P<0.05);the difference between group B and group D was statistically significant(P<0.01).There was no significant difference between the four groups after anesthesia(P>0.05).Conclusions: 1.The pre-anesthesia ONSD,the dose of ropivacaine,BMI and post-anesthesia MAP are factors of the anesthesia plane.2,the optic nerve sheath diameter ≥ 5.3mm in the intrathecal injection of 12 mg ropivacaine 15 minutes after the anesthesia plane and optic nerve sheath diameter < 5.3mm maternal intrathecal injection of 15 mg ropivacaine anesthesia plane,can be measured by measuring the diameter of the optic nerve sheath Intrathecal ropivacaine dose.