Ge Mingyue, Wang Sheng, Dai Zhigang, Li Yan, Xie Liping, Liu Xuejao, Yin Jiangwen
Department of Anesthesiology, First Affiliated Hospital, School of Medicine, Shihezi University, Shihezi, Xinjiang 832002, P.R. China.
Biomed Rep. 2017 Mar;6(3):295-299. doi: 10.3892/br.2017.846. Epub 2017 Jan 25.
The aim of the study was to investigate the effects of ephedrine intrathecal injection on maternal thermodynamics and spinal nerve block in cesarean section. A total of 107 patients undergoing elective cesarean section under combined spinal epidural anesthesia were randomly divided into two groups: group E: Bupivacaine (6 mg) combined with ephedrine (15 mg) and group C: Bupivacaine (6 mg). Systolic blood pressure (SBP), diastolic blood pressure (DBP), heart rate (HR), the incidence of hypotension, hypertension, tachycardia, nausea and vomiting were all recorded. The umbilical vein blood gases and noradrenaline, as well as maternal peripheral venous blood were analyzed. The time of high-quality spinal block was also recorded. Postoperatively, 1 day, 2 days bedside follow-up and 7, 21, 35 days telephone follow-up were carried out to determine any neurological deficit maternal performance. SBP and DBP decreased in group C but not in group E at 3 min after spinal anesthesia and 1 min after delivery (P<0.05). From 3 min post-anesthesia to the end of surgery, the HR levels in the C group were significantly higher than those of the E group (P<0.05). The incidence of hypotension, tachycardia, nausea and vomiting and neonate acidosis was low in group E compared with group C (P<0.05). The time of high-quality spinal block in group E was longer than that of group C (P<0.05). After spinal anesthesia, the concentration of noradrenaline from maternal peripheral venous blood was low in group C but high in group E compared with before spinal anesthesia (P<0.05). Ephedrine combined with low-dose bupivacaine intrathecal injection effectively maintained maternal hemodynamics and prolonged the time of sensory spinal block.
本研究旨在探讨剖宫产术中麻黄碱鞘内注射对产妇热力学及脊神经阻滞的影响。选取107例行腰麻-硬膜外联合麻醉下择期剖宫产的患者，随机分为两组：E组：布比卡因（6 mg）联合麻黄碱（15 mg）；C组：布比卡因（6 mg）。记录收缩压（SBP）、舒张压（DBP）、心率（HR）、低血压、高血压、心动过速、恶心和呕吐的发生率。分析脐静脉血气、去甲肾上腺素以及产妇外周静脉血。记录高质量脊麻阻滞时间。术后进行1天、2天床边随访以及7天、21天、35天电话随访，以确定产妇有无神经功能缺损表现。脊麻后3分钟及分娩后1分钟，C组SBP和DBP下降，E组未下降（P<0.05）。麻醉后3分钟至手术结束，C组HR水平显著高于E组（P<0.05）。与C组相比，E组低血压、心动过速、恶心呕吐及新生儿酸中毒的发生率较低（P<0.05）。E组高质量脊麻阻滞时间长于C组（P<0.05）。脊麻后，与脊麻前相比，C组产妇外周静脉血去甲肾上腺素浓度低，E组高（P<0.05）。麻黄碱联合低剂量布比卡因鞘内注射可有效维持产妇血流动力学，并延长感觉性脊麻阻滞时间。
