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| Effect of sevoflurane combined with epidural anesthesia during cesarean section of puerperae with severe preeclampsia and its influence on their hemodynamics and analgesic effect |
| Suining Central Hospital, Suining, Sichuan Province, 629000 |
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Abstract To explore the effect of sevoflurane combined with epidural anesthesia during cesarean section of puerperae with severe preeclampsia, and to study its influence on the hemodynamics and analgesic effect of the puerperae. Methods: 120 puerperae with severe preeclampsia who wanted cesarean section were selected and were divided into two groups (60 cases in each group) by the random number table method between September 2018 and September 2021. The puerperae in observation group were given sevoflurane combined with epidural anesthesia, while the puerperae in control group were given epidural anesthesia only. The hemodynamics values, such as systolic blood pressure (SBP), diastolic blood pressure (DBP), heart rate (HR), blood oxygen saturation (SpO2) at different analgesic time points, the analgesic effect by Visual Analogue Scale (VAS) in 1, 5, 15 and 30 min after surgery, and the sedation effect evaluated by Ramsay sedation score in 4, 8, 12, 24 and 48 h after surgery, and comfortable degree evaluated by Bruggrmann Comfort Scale (BCS) of the puerperae were compared between the two groups. The occurrence of adverse reactions, neonatal Apgar score, and intraoperative blood loss of the puerperae were also compared between the two groups. Results: There were significant differences in the values of SBP and HR of the puerperae between the two groups, among different time points, and between the interactions, and there was significant difference in the value DBP of the puerperae between the two groups and between interactions (all P＜0.05). There was no significant difference in the value of DBP of the puerperae among different time points, and there was no significant difference in the value SpO2 of the puerperae between the two groups, among different time points, and between interactions (all P＞0.05). The values of SBP, DBP, and HR at T2, and the HR value at T3 of the puerperae in the observation group were significantly lower than those of the puerperae in the control group. The values of SBP, DBP, and HR at T2, and the HR value at T3 of the puerperae in the control were significantly high than those at T0 (all P＜0.05). There was significant difference in the VAS score of the puerperae between the two groups, and among different time points. The VAS scores of the puerperae in the observation group at 1, 5, 15, and 30min after operation were significantly lower than those of the puerperae in the control group (all P＜0.05). The Ramsay sedation score of the puerperae in the two groups had significant difference among different time points (P＜0.05), but which had no significant difference between the two groups and between the interactions (all P＞0.05). The BCS score of the puerperae had significant difference between the two groups and among different time points (all P＜0.05), but which had no significant difference between the interactions (P＞0.05). There were no significant differences in the scores of Ramsay sedation and BCS of the puerperae in 4, 8, 12, 24, and 48 hours after operation between the two groups (all P＞0.05). There were no significant differences in the adverse reactions rate, the neonatal Apgar score, and the intraoperative blood loss of the puerperae between the two groups (all P＞0.05). Conclusion: Sevoflurane combined with epidural anesthesia during cesarean section of puerperae with severe preeclampsia can effectively stabilize their hemodynamics, with better analgesic effect and safety.
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