Clinical observation of combined spinal epidural anesthesia(CSEA)of small dose of sufentanil combined with bupivacaine in cesarean section for patients with pregnancy induced hypertension(PIH)

Objective To evaluate the efficacy and safety of combined spinal epidural anesthesia(CSEA) of small dose of sufentanil combined with bupivacaine in cesarean section for patients with pregnancy induced hypertension(PIH).Methods 60 one-fetus pregnant women,who had PIH,pre-eclampsia and was going to undergo cesarean section were randomly divided into 3 groups on average : group D(with7.5 mg bupivacaine),groupG(with10 mg bupivacaine),and groupH(with 5 μg sufentanil+7.5 mg bupivacaine) according to different dosages and formula of spinal anesthesia.Their MAP and HR changes at the 5th min,10th min,15th min and 30th min before and after anesthesia were observed and recorded,respectively.The onset time of sensory block and motor block,the highest level of anesthesia,duration of sensory and motor block and muscle loose effect in all of the groups were evaluated and recorded.The Apgar score of newborns were recorded in 1 min and 5 mins after birth.In addition,the incidence rates of chest congestion,rigors,nausea,vomiting and respiratory depression in the 3 groups were recorded.Results 5 mins after anesthesia,the MAP,HR of all groups reduced,but group G reduced more obviously than other groups(P0.05).12 patients of group G needed ephedrine injection and the incidence rates of chest congestion,rigors,nausea and vomiting were higher than those in group D and group H.There was no significant difference in the comparison of onset time of sensory block and motor block among the 3 groups(P0.05).Besides,the highest level of anesthesia in 10 cases of group D could not meet the demand of the surgery.It is necessary to add local anesthesia to epidural anesthesia,and there was significant difference in this aspect between group D and group H(P0.05).In addition,1 min and 5 mins after the birth,there was no significant difference in Apgar scores of the newborns(P0.05).Conclusion CSEA of small dose of 5μg sufentanil combined with 7.5mg bupivacaine has little hemodynamics influence on patients with PIH.It has quick effect,excellent blockade,good effect of muscle relaxation,short duration of sensory and motor block,few adverse reactions and discomfort on patients.Thus,it is worth popularizing.