Effect Of HEAS Preload On Mother And Neonate During Selective Cesarean Section Under Combined Spinal Epidural Anesthesia

ObjectiveTo observe and compare the effects of HEAS and Ringers solution preload on mother and neonate during cesarean section under combined spinal epidural anesthesia.MethodsSixty patients scheduled for cesarean section under combined spinal epidural anesthesia were randomly divided into HEAS group(group H n=30)and Ringers solution group(group L n=30).The two groups received either 500ml of HEAS or 500ml of Ringers solution prior to anesthesia over a 30_min period.SBP DBP MAP HR were recorded at entering into the room,before anesthesia and at 3min,5min,10min after anesthesia respectively.And maternal and umbilical cord blood gas were analysized following immediate delivery. Maternal venous blood was collected at entering into the room, and maternal and umbilical cord blood were collected at delivery to measure SOD , MDA, ET and ANP.ResultsAt 3, 5, 10min after anesthesia SBP in two groups and DBP in group L was lower than that at entering into the room. At 5min DBP in group Hdecreased. SBP in group L decreased at the end of the operation while HR increased at 3, 5min. SBP and DBF in group L were lower than group H at 3, 5min after anesthesia, the end of the operation and 3,5, 10min respectively, but HR was higher at 5min. In addition, group H not only had higher minSBP and DBP but also lower maxHR, the mean dose of ephedrine required and incidence of hypotension . Group H had higher maternal PO2 but lower Lac. The maternal venous levels of SOD in the two groups are less at delivery than at entering into the room0 At delivery the maternal venous level of SOD in group H is greater than group L. The umbilical arterial and venous levels of SOD in group H is greater than group L, but the levels of MDA is less. The maternal venous levels ofANP in the two groups are higher at delivery than at entering into the room,but the level of ET is lower in group H.ANP level in maternal venous and umbilical cord arterial blood samples is higher at delivery in group H than that in group L.While ET level is lower in group H than that in group L.In addition,the umbilical cord arterial plasma ANP levels in two groups are higher than those of the umbilical cord venous plasma .ConclusionHEAS is so better in improving hemodynamic ,keeping homeostasis that it can significantly increase organ and tissue perfusio of blood,improve microcirculation and uteroplacental blood flow and benefit maternal and neonatal during cesarean section.