Comparison Of Hyperbaric And Isobaric Bupivacaine In Clinical Anesthesia For Cesarean Section

Objective:to compare the effects of bupivacaine with different proportion on puerperas and fetus in cesarean section and clinical effect Method:100 cases of parturients undergoing caesarean section in our hospital in Mar-dec of 2017 were randomly divided into two groups,the group of isobaric bupivacaine(I group)and the group of hyperbaric bupivacaine(H group)50 cases each.The parturients were basically in the ASA grade at the I-II grade,aged 20-35,between 155-175 cm and 50-80 kg.No serious systemic disease,fetal distress,placenta implantation and other obstetric complication,no contraindication of lumbar and hard.Combined spinal epidural anaesthesia was performed on all the parturients who lying on the left side,then the H group was performed 2.2-2.5ml(2ml of bupivacaine+1ml 10% glucose),and the I group was performed 2.2-2.5ml(2ml of bupivacaine and 1ml of cerebrospinal fluid).0.5mg atropine was given after the bradycardia(heart rate <55 /min)during the operation,when blood pressure is lower than 90 mmHg or down more than 30% of blood pressure,40 ug deoxyadrenaline was administered for resistance to a drop in blood pressure,repeatable,until the blood pressure fluctuating within 20% base blood pressure range.After fetal birth,the blood gas analysis of umbilical cord blood was extracted by the assistant of the operation,and the Apgar score was performed when first minute after the birth of the fetus.After the operation,the parturient was visited and the effect of anesthesia was evaluated.The general situation were recorded: age,height and weight,anesthesia until birth time,a basal blood pressure,heart rate and blood oxygen saturation,intraoperative pain of VAS grade and atropine dosage,adverse reaction of nausea and vomiting.Results:There was no significant difference in the basic information of the two groups,the time from anaesthesia to operation,the time of the surgery and the blood pressure in the surgical operation.It was also no significant difference in the pH of fetal blood gas and Apgar score of the two groups.Compared with the H group,the total need of Phenylephrine was less in the I group,and P<0.05 had statistical significance.The number of bradycardia in H group was more than that of I group,and was statistically significant.The two groups met the requirements of the operation,and there was no significant difference in the classification of the pain and the satisfaction of the anesthetic effect during the operation.There was no statistical difference in P>0.05.Conclusion:All the two methods of anesthesia can meet the needs of the operation and can be used for caesarean section.Isobaric bupivacaine has less influence on the stability,less incidence of bradycardia and incidence of perioperative nausea and vomiting.The effects of bupivacaine on fetal blood gas pH and Apgar score were not significantly different.