Comparison Of Risk Of Hypotension Between Cesarean Section In Pregnant Women With Severe Preeclampsia And Healthy Pregnant Women Under Combined Spinal-epidural Anesthesia

Objective: to investigate the risk of low blood pressure of pregnant women with severe preeclampsia and healthy pregnant women under combined anesthesia.Methods: collected in August 2016 to August 2017 of 40 cases of severe preeclampsia hospitalized pregnant women as severe preeclampsia group,pregnant women and collect in the same period of 240 cases of hospitalized as healthy pregnant women group maternal health,enter 500 ml voluven before anesthesia,with 10 ml/kg capacity input sodium lactate ringer's solution,take their knees arch left side,in the third and forth lumbar vertebra clearance(that is,the L3-4)using after the middle of the piercing into the road to epidural puncture,after waiting for resistance to disappear into the epidural space,put the hard membrane lumbar hemp needle wear out arachnoid,into the subarachnoid space,stay within 20 s after cerebrospinal fluid injection 7.5 mg0.5 % than paid mixture proportion of heavy cloth cloth than paid(0.75% hydrochloric acid injection 2 ml + 10%glucose injection 1 ml),lumbar hemp pulls needles into epidural catheter,epidural catheterization cavity 4 cm deep.The anaesthesia block was controlled by the level of the lower margin of the bilateral costal arch(T8)and the lower level of the xiphoid(T6).Acupuncture method to detect pain block plane,plane when sensory blockade below T8,immediately into 3 ml test dose of 2% lidocaine hydrochloride injection,5 minutes after injection 5 ~ 15 ml2 % of lidocaine hydrochloride injection to maintain anesthesia.Intravenous ephedrine injection was performed when the systolic blood pressure<100mm Hg or mean artery was reduced to 80% of the underlying value during anesthesia.Observe and record two groups of pregnant women under the waist hard joint anesthesia during lidocaine dosage,infusion volume,total dose ephedrine,newborn apgar score,SBP,DBP,MAP,HR,number of nausea during anesthesia.Results: The amount of lidocaine,ephedrine use and infusion volume were significantly lower than those in healthy pregnant women group,and the incidence of hypotension was significantly higher than that in the healthy pregnant group(P<0.05);SBP,DBP and MAP base values,SBP,DBP and MAP were the lowest value,the lowest blood pressure drop degree and the basic value-the lowest blood pressure value was significantly higher than the healthy pregnant group(P<0.05).HR basic value,lowest and lowest degree of heart rate decreased after anesthesia,after anesthesia,basic value-the lowest rate and high group were significantly higher than that of healthy pregnant women(P < 0.05),the highest degree of heart rate increase and the maximum heart rate-based value were significantly lower than that of healthy pregnant women group(P < 0.05);There was a significant difference(P<0.01).There was no significant difference in neonatal apgar score in pregnant women with severe preeclampsia(P < 0.05).Conclusion: severe preeclampsia in pregnant women waist hard joint anesthesia downlink cesarean section the risk of low blood pressure is higher,so the need to adjust the waist hard joint anesthesia drug dose and vascular active drug dose,and strengthen the management of intraoperative intravenous infusion.