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| Effects of the combined spinal-epidural anesthesia with different concentrations of ropivacaine used in cesarean section of pregnant women with gestational diabetes mellitus on their postoperative pain and micro-circulation |
| The First Affiliated Hospital of Henan University of Traditional Chinese Medicine, Zhengzhou, Henan Province, 450000 |
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Abstract To explore the effects of the combined spinal-epidural anesthesia with different concentrations of ropivacaine used in cesarean section of pregnant women with gestational diabetes mellitus (GDM) on their postoperative pain and micro-circulation. Methods: A total of 96 pregnant women with GDM who wanted cesarean section in selected time were selected and were random divided in three groups (32 cases in each group) between June 2019 and October 2020. During the combined spinal-epidural anesthesia in the cesarean section, the women in group A were given 0.25% ropivacaine, the women were given in group B 0.375% ropivacaine, and the women in group C were given 0.5% ropivacaine. The anesthesia effect of the women was compared among the three groups. The degrees of static and dynamic postoperative pain of the women were evaluated by visual analogue scale (VAS). Before surgery, and at 24h and 48h after surgery, the micro-circulation indexes values of the women in the three groups were detected by nailfold micro-circulation tester. The mean arterial pressure (MAP) and heart rate (HR) values of the women in the three groups at 15min after anesthesia and 2h after surgery were monitored. The incidence of adverse reactions during anesthesia of the women was compared among the three groups. Results: The anesthesia block time, the Bromage score, and the sensory block level of the women in group C were significantly higher than those of the women in group A and group B, and the static VAS scores at 2 h and 4 h after cesarean section, and the dynamic VAS scores of the women in group C at 1 h, 2 h and 4 h after cesarean section were significantly lower than those of the women in group A and group B. The length and the width of loops of the women in group C at 24 h and 48 h after cesarean section were significantly higher than those of the women in group A and group B (all P<0.05). After 15 min of anesthesia, the MAP value of the women in group A was significantly higher than that of the women in group B and group C, the HR value of the women in group A was significantly lower than that of the women in group B and group C, and the incidence of total adverse reactions (6.3%) of the women in group A was significantly lower than that (18.8%) of the women in group B and that (31.3%) of the women in group C (all P<0.05). Conclusion: The combined spinal-epidural anesthesia with different concentrations of ropivacaine used in cesarean section of the women with GDM has better anesthetic effect, and 0.5% ropivacaine has the best postoperative analgesic effects and has the lowest influence on the micro-circulation of the women. While 0.25% ropivacaine has fewer effect on the maternal hemodynamics with lower incidence of adverse reactions.
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