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| Effect of intraspinal anesthesia by ropivacaine combined with lidocaine under ultrasound guidance used in caesarean section of obese women with pregnancy-induced hypertension |
| Chun'an County Maternal and Child Health Care Hospital, Hangzhou Zhejiang Province, 311700 |
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Abstract To explore the effect of intraspinal anesthesia by ropivacaine combined with lidocaine under ultrasound guidance used in caesarean section of obese women with pregnancy-induced hypertension(PIH). Methods: 96 obese women with PIH who wanted caesarean section were divided into two groups(48 cases in each group) by the random number table method from January 2020 to July 2022. The women in the observation group received the intraspinal anesthesia by ropivacaine combined with lidocaine under ultrasound guidance used in caesarean section, and the women in the observation group received the traditional intraspinal anesthesia by ropivacaine combined with lidocaine. The puncture condition and the anesthesia effect of the women were compared between the two groups. Results: There was no significant difference in the puncture success rate(100% vs. 89.6%) of the women between the two groups(P>0.05). The incidence of puncture related complications(4.2%) of the women in the observation group was significantly lower than that(20.1%) of the women in the control group. The lumbar space positioning time(1.50±0.36 min), the anesthesia puncture time(4.40±1.17 min), the onset time of anesthesia(11.70±2.24 min) and the puncture number(1.12±0.30 times) of the women in the control group were significantly lower than those(4.12±1.18 min, 7.25±1.20 min, 16.00±2.35 min and 1.84±0.50 times) of the women in the control group. The rate of anesthetic effect of grade I(97.9%) of the women was significantly higher than that(85.4%) of the women in the control group. The blood pressure value of the women in the two groups at 10 minutes after anesthesia had decreased significantly, but the change range of which of the women in the observation group was significantly less than that of the women in the control group. The levels of serum cortisol, C-peptide and advanced oxidation protein products of the women in the two groups in 12 hours after operation had increased significantly, but the change ranges of which of the women in the observation group were significantly less than those of the women in the control group(all P<0.05). There were no significant differences in the umbilical artery blood gas indexes values and Apgar scores at 1min and 5min after delivery of the newborns between the two groups(P>0.05). Conclusion: Ultrasound-guided intravertebral anesthesia by ropivacaine combined with lidocaine during caesarean section of the obese women with PIH can improve the success rate of puncture, reduce the related complications, and which has less influence on the maternal hemodynamics and stress hormones, and with good anesthesia effect.
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