The application value of combined spinal-epidural anesthesia in cesarean section

Objective To explore the application effect and complications of combined spinal-epidural anesthesia in cesarean section. Methods 84 pregnant women who planed to undergo cesarean section were divided into the observation group and the control group by the random number table method, 41 cases in each group.The observation group was given combined spinal-epidural anesthesia, while the control group was given epidural anesthesia.The anesthetic effects, perioperative hemodynamic changes and the incidence of postoperative complications were evaluated. Results The excellent and good rate of anesthesia in the observation group was significantly higher than that in the control group(100.00% vs.87.80%)(χ2=5.325, P<0.05). The mean arterial pressure(MAP) of the observation group when the plane of sensory block was fixed(T1), at the beginning of operation(T2), at fetal delivery(T3) and at the end of operation(T4) were significantly lower than those of the control group(t=3.893, 3.934, 3.991, 2.231, all P<0.05). The onset time of anesthesia, duration of anesthesia and Bromage score of the observation group were significantly better than those of the control group(t=14.425, 15.791, 4.655, all P<0.05). The incidence rate of supine syndrome in the observation group was significantly higher than that in the control group(26.83% vs.4.88%)(χ2=7.405, P<0.05). Conclusion Compared with epidural anesthesia, combined spinal-epidural anesthesia has characteristics of fast onset and long duration, and the anesthetic effect is clear.However, it is relatively unstable in terms of hemodynamics, and the incidence of supine syndrome is significantly higher. Key words: Cesarean section; Anesthesia, epidural; Anesthesia, spinal; Hemodynamics