Comparison The Effects Of Epidural Anesthesia And Spinal Anesthesia On Maternal Temperature And Shiver In Cesarean Section

ObjectiveHypothermia and shiver are common complications in cesarean section.This study measured maternal temperature and shiver of cesarean section during epidural anesthesia and spinal anesthesia.The different effects of anesthesia on maternal body temperature and shiver were compared,and the possible regulatory mechanisms were explored.MethodsIn this study,20 women who underwent cesarean section were selected and randomly divided into epidural anesthesia group and spinal anesthesia group.The sample size of the two groups was 11 and 9 respectively.Both groups used 2%lidocaine and 0.75%ropivacaine as an anesthetic.Sedative drugs and intravenous anesthetics are not used during surgery,and unwarmed liquid is intravenously administered without any heating device.The maternal core temperature of anesthesia induction(T0),5 min(T1),10 min(T2),15 min(T3),20 min(T3),30 min(T4),45 min(T5)and 60 min(T6)were recorded.Grading of shiver according to Wrenck grading,blood pressure and heart rate at various time points were recorded.The patient's height,weight,ambient temperature,and the highest sensory block dermatome of the mother during surgery were also recorded.The core body temperature at which shiver are triggered is the shiver threshold.Finally,all data were statistically analyzed using SPSS 25.0 software.The results of core body temperature were expressed as mean ± standard deviation,and the shivering results were expressed by grade indicators.The core body temperature changes in the two groups were compared using repeated measures of variance analysis.The maternal shiver were compared using the Friedman rank sum test(repeated measures).The shiver thresholds of the two groups were compared using the Mann-Whitney U test.The anesthesia induction time was 0.When P<0.05,the difference between the two groups was statistically significant.Results(1)The core body temperature of the mothers during the two methods of intravertebral anesthesia:the core body temperature of the two groups of women was in a downward trend in the first half hour after induction of anesthesia,and the rate of decline was close.After half hour,the core body temperature of the women in the spinal anesthesia group was significantly faster.Statistical results showed that there was a statistically significant difference in the degree of core body temperature decline between the two groups during the entire cesarean section(Epsilon=0.552,P=0.018).(2)The occurrence of maternal shiver during the two methods of intravertebral anesthesia:the incidence of maternal shiver in the spinal anesthesia group was only 2/11,and the incidence of maternal shiver in the epidural anesthesia group was 6/9,the difference was statistically significant(P=0.031),and the incidence of maternal shiver in the epidural group was more severe than that in the spinal anesthesia group,and the maternal complaint had significant discomfort.(3)There is no significant relationship between the occurrence of shiver and changes in core body temperature.Because of the low incidence of shiver in the spinal anesthesia group,the sample size is too small to measure the shiver threshold.There was no significant relationship between the maternal blood pressure and heart rate and shiver in cesarean section(P>0.05).ConclusionsDifferent intravertebral anesthesia have different effects on maternal core body temperature and shiver.Although the core body temperature of the mother during epidural anesthesia drops faster during spinal anesthesia,the incidence and severity of shiver were lower,and there was no significant relationship between shiver and core body temperature.However,due to the lack of sample size,we were unable to compare the shiver thresholds and explore the effects of anesthesia on the shiver threshold,which requires the inclusion of larger samples to increase the reliability of the article.However,the results of this experiment still show that thermoregulation was impaired more by spinal anesthesia than by epidural anesthesia.The results of this study also provide new ideas for the study of the mechanism of shiver.