Department of Anesthesiology, Daqing Longnan Hospital, Daqing, P.R. China.
Eur Rev Med Pharmacol Sci. 2018 Mar;22(6):1825-1829. doi: 10.26355/eurrev_201803_14602.
To compare the effects of sevoflurane or propofol combined with remifentanil anesthesia on the clinical efficacy and stress response of pregnancy-induced hypertension (PIHS) in cesarean section.
150 patients with PIHS and treated with cesarean section in our hospital from May 2015 to September 2016 were selected. All patients were randomly divided into sevoflurane-remifentanil group (n=75) and propofol-remifentanil (n=75). The elbow blood of patients in both groups were collected, the levels of Norepinephrine (NE) adrenaline (AD), cortisol and blood glucose in plasma were compared at before anesthesia induction (T0), operation 30 min (T1), end of operation (T2), 2 h after operation (T3), 24 h after operation (T4). The blood pressure control, muscle control, anesthesia onset time, maternal pain and complications were compared between the two groups.
The patients in the sevoflurane group were superior to the propofol group (p<0.05) in terms of muscle control effect, anesthesia onset time and maternal pain. There was no significant difference between the two groups in terms of blood pressure control and anesthesia complications (p>0.05). There was no significant difference in plasma AD, NE, cortisol and blood glucose between the two groups before induction of anesthesia (p>0.05). However, the plasma markers of the two groups began to increase after anesthesia induction and reached peak at T2 or T3, returned back to preoperative level or higher than before surgery at T4. The levels of AD, NE, cortisol and blood glucose in plasma of sevoflurane group were significantly lower than those in propofol group at T1-T4 time point, the difference was statistically significant (p<0.05).
The clinical efficacy of sevoflurane combined with remifentanil anesthesia is better than that of propofol combined with remifentanil, and it can effectively reduce the stress of pregnant women with pregnancy-induced hypertension treated with cesarean section.
比较七氟醚或丙泊酚复合瑞芬太尼麻醉对剖宫产术妊娠高血压（PIHS）患者的临床疗效及应激反应的影响。
选取 2015 年 5 月至 2016 年 9 月在我院行剖宫产术的 150 例 PIHS 患者，采用随机数字表法分为七氟醚-瑞芬太尼组（n=75）和丙泊酚-瑞芬太尼组（n=75）。采集两组患者肘静脉血，比较两组患者麻醉诱导前（T0）、手术 30min（T1）、术毕（T2）、术后 2h（T3）、术后 24h（T4）时血浆中去甲肾上腺素（NE）、肾上腺素（AD）、皮质醇及血糖水平；比较两组患者血压控制情况、肌松效果、麻醉起效时间、产妇疼痛情况及并发症发生情况。
七氟醚组患者肌松效果、麻醉起效时间及产妇疼痛评分均优于丙泊酚组（p<0.05）；两组患者血压控制情况及麻醉并发症比较差异无统计学意义（p>0.05）。两组患者麻醉诱导前 AD、NE、皮质醇及血糖比较差异无统计学意义（p>0.05）；两组患者麻醉诱导后血浆标志物均开始升高，于 T2 或 T3 时达高峰，于 T4 时恢复至术前水平或高于术前。T1-T4 时，七氟醚组患者 AD、NE、皮质醇及血糖均低于丙泊酚组，差异有统计学意义（p<0.05）。
七氟醚复合瑞芬太尼麻醉的临床效果优于丙泊酚复合瑞芬太尼，能有效减轻剖宫产术治疗的妊娠高血压产妇的应激反应。
