Effects Of Hemodynamic For Parturients During Cesarean Section Using Different Vasoconstrictor

Objective:To compare the effects of phenylephrine,ephedrine and dopamine on maternal hemodynamic of puerperas doing cesarean delivery.In that case,we can use vasoconstrictor rationally.Methods:Choose 200 women undergoing elective cesarean section with spinal anesthesia,ASA levels from ???,all of whom were late pregnancy singletons.Patients were randomly divided into A?B?C?D four groups,n=50.Groups A?B?D were given ephedrine,phenylephrine and dopamine when blood pressure drops,the infusion should be sped up when blood pressure drops in group C.During the operation,record the following data,choice of clearance,local anesthetics dose,time of anesthesia,operating time,bleeding volume(after delivery),transfusion volume.pH,PO2,PCO2,BE of maternal umbilical veins.We recorded hemodynamics parameters like the blood pressure,heart rate,CO,CI,SV,LVET from patients got into the operating room.Collect all the data and do statistic analysis,to compare the functions of the three drugs on maternal hemodynamics and umbilical vein blood gas analisis results.Results:Hypotension occurred in 152 cases of the 200,the blood pressure of the other 48 cases did not drop.The general information and the intraoperative situations showed no statistically significant differences(P>0.05).The comparison of the four groups of maternal hemodynamics:(1)The BP of the groups A?B and D began to decline after anesthesia,but there was no statistically significant difference among groups(P>0.05).1 minute after giving three drugs,the BP of three groups all increased,groups B and D increased obviously compared with group A(P<0.05).After 5 minutes,the BP of the three groups returned to the basic level,there was no statistically significant difference among groups(P>0.05).The BP of group D fell slightly after 10 minutes,and the difference was statistically significant compared with group A(P<0.05).(2)The HR of group A increased after ephedrine intravenous injection,there were statistically significant differences compared with groups D and B(P<0.05).The HR of groups B and D declined after drug infusion,and there were significant differences compared with group A(P<0.01),but there was no statistically significant difference between the two groups(P>0.05).(3)The CO and CI of group A increased significantly after 5 minutes after ephedrine intravenous injection,higher than groups D and B(P<0.01),and there were statistically significant differences between group D and B(P<0.05).(4)The SV of group B increased significantly after phenylephrine intravenous injection than group D and group A(P<0.01),and there was statistically significant differences between group A and D(P<0.05).(5)The LVET of group A increased after 5min after ephedrine injection(P<0.01).(6)The pH of group B was higher than other groups(P<0.05).Conclusion:The three drugs can maintain circulation stability in time,but phenylephrine has more effective function on circulation stability and heart rate than the other two drugs,it is worth for clinical references.