Combined Spinal-epidural Anesthesia for Cesarean Section Without Prophylactical Prehydration and Vasopressors
Status:
Recruiting
Trial end date:
2021-11-30
Target enrollment:
Participant gender:
Summary
Hypotension is a common complication in pregnant women after spinal anesthesia and related
with the dose of local anesthetic. Injecting small dose local anesthetic into subarachnoid
space can decrease the incidence of hypotension, but increase the risk of incomplete
analgesia and muscle relaxation. The investigators hypothesize there is an optimal dose of
bupivacaine and ropivacaine for subarachnoid injection in pregnant women, which can cause
enough anesthesia and obviously decrease the incidence of hypotension without prophylactical
prehydration and vasopressors. To verify this hypothesis, full-term pregnant women who were
scheduled for elective cesarean section were recruited.Combined spinal-epidural anesthesia
was performed for pregnant women after written informed consents. The dose of bupivacaine or
ropivacaine is small and depends on height of pregnant women. The blood pressure, heart rate,
respiratory rate, SpO2 and fetal heart rate were recorded and the blood flow volume of
uterine artery was monitored The sensory and motor block were evaluated. After delivery,
umbilical blood samples were taken for blood gas analysis. APGAR scores and neurological
behavior of infant were evaluated and recorded. In the intraoperative period, side-effects
and requirement for sedation, epidural injection or general anesthesia were noted. The
quality of anaesthesia (judged by the anaesthetist), the quality of muscle relaxation (judged
by the surgeon) and the degree of intraoperative comfort (judged by the patient) were
recorded as excellent, good, fair or poor.