The Effect Of Low Dose Sufentanil Spinal Anesthesia On Inadvertent Perioperative Hypothermia In Cesarean Section Women

Objective:Hypothermia in perioperative period can lead to a series of adverse outcomes for both mothers and newborns.Drug intervention is a common method used by anesthesiologists.It has been reported that intrathecal injection of opioids can affect the body temperature and shiver of parturients,but there are different research results.In recent years,sufentanil combined with bupivacaine is widely used in cesarean section.The purpose of this study was to explore the effect of subarachnoid injection of 2.5ug sufentanil combined with bupivacaine on the body temperature and the incidence of shivering in cesarean section women.Methods: One hundred and twenty women of ASA I-II grade,aged 21-44 years and 37-41 weeks of gestation in our hospital were selected.According to the inclusion criteria and exclusion criteria,cesarean section with lumbar anesthesia was selected to eliminate contraindications of lumbar anesthesia puncture,allergies to opioids or local anesthetics,preoperative temperature abnormalities and regulatory obstacles,and to estimate the pregnant women with massive bleeding.According to the random scale,they were randomly divided into control group(Group C,0.75% bupivacaine 8-12mg)and experimental group(Group S,on the basis of the control group,sufentanil citrate 2.5ug was added).After entering the room,the vital signs and axillary temperature were routinely monitored and inhaled with 100% oxygen 5-6L / min mask.At the beginning of anesthesia,both groups were given 5-8ml / kg / h hydroxyethyl starch intravenously,and lumbar anesthesia was performed through L3-4 space.After cerebrospinal fluid outflow,the diluent solution was injected to 2ml for about 15 s.After anesthesia,tilt left 30 ?,adjust the anesthesia plane to T6 or T8,and then start the operation.Main outcome measures: axillary temperature of T1(5min before anesthesia),T2(10min after anesthesia),T3(30min after anesthesia),T4(60min after anesthesia),T5(end of operation),wrench score of shivering,thermal comfort score of PMV,nausea,vomiting,pruritus of skin,etc.Secondary outcome measures: maternal hypotension,bradycardia,time of anal exhaust and time of getting out of bed activity,Apgar score of 1 and 5 minutes of newborns,body temperature immediately after birth,etc.Results: Finally,sixty cases in group S and fifty-eight cases in group C were included.Compared with T1,the axillary temperature in T3-T5 time point decreased significantly(P < 0.05),but there was no significant difference between the two groups(P > 0.05).Compared with bupivacaine alone in group C,sufentanil injection in subarachnoid space significantly reduced the incidence of shivering(P < 0.05),but increased the incidence of pruritus and vomiting(P < 0.05).There was no significant difference in nausea,hypotension,bradycardia,anal exhaust time and out of bed activity time(P > 0.05).There was no significant difference in Apgar score and body temperature at birth(P > 0.05).Conclusion:The body temperature of the parturients in the period of cesarean section decreased to some extent.The effect of 2.5ug sufentanil combined with bupivacaine on the body temperature was not significant,which could significantly reduce the incidence of shivering in the parturient and had no adverse effect on the newborns.In addition,it can increase the occurrence of pruritus and vomiting of the skin of the parturients,and has no serious adverse reactions to the prognosis of the parturient,which is worthy of clinical promotion.