Influence of Combined Spinal-epidural Anesthesia and General Anesthesia on Adverse Events of Cesarean Section and Prognosis of Mother and Infant in Pregnant Women with Hypertension
HAN Ming, LIU Miao, ZHANG Dan
Department of Anesthesiology,Weinan Maternal and Child Health Hospital, Weinan Shaanxi 714000
Abstract：【Objective】To investigate the impact of combined spinal-epidural anesthesia (CSEA) and general anesthesia on adverse events during cesarean section and maternal-infant outcomes in pregnant women with hypertension. 【Methods】A total of 84 pregnant women with pregnancy induced hypertension (preeclampsia) admitted to our hospital were randomly divided into two groups,with 42 cases in each group. All women underwent cesarean section,with the control group receiving general anesthesia and the observation group receiving CSEA. The anesthesia conditions and perioperative hemodynamic changes were compared between the two groups. Apgar scores at 1 minute and 5 minutes after birth and umbilical artery blood gas parameters of newborns were compared. The occurrence of anesthesia-related adverse events and maternal-infant outcomes during hospitalization were compared between the two groups. 【Results】 The onset time of anesthesia and the time from anesthesia initiation to delivery were longer in the observation group than in the control group (P<0.05). At the time of fetal delivery (T1),both groups showed a significant decrease in heart rate and mean arterial pressure compared to before anesthesia (T0) (P<0.05). At the end of surgery (T2),heart rate in both groups increased compared to T0 and T1,while mean arterial pressure was lower than T0 and higher than T1,with statistically significant differences (P<0.05). The heart rate and mean arterial pressure at T1 and T2 were higher in the observation group than in the control group (P<0.05). Apgar scores at 1 minute and 5 minutes after birth in the observation group were higher than that in the control group (P<0.05). The observation group had lower carbon dioxide partial pressure (PCO2) and higher oxygen partial pressure (PO2) in newborns compared to the control group (P<0.05). There was no statistically significant difference in the occurrence rate of overall anesthesia-related adverse reactions and maternal adverse events between the two groups (P>0.05),while the occurrence rate of adverse events in newborns was lower in the observation group than in the control group (P<0.05). 【Conclusion】Both CSEA and general anesthesia have advantages and disadvantages in cesarean section for pregnant women with preeclampsia due to hypertension. General anesthesia has minimal impact on maternal hemodynamics and provides rapid onset of anesthesia but may adversely affect neonatal outcomes. Compared to general anesthesia,CSEA can more effectively ensure the safety of newborns.
韩明, 刘苗, 张丹. 腰硬联合麻醉与全麻对妊高征产妇剖宫产术不良事件及母婴预后的影响[J]. 医学临床研究, 2023, 40(8): 1150-1153.
HAN Ming, LIU Miao, ZHANG Dan. Influence of Combined Spinal-epidural Anesthesia and General Anesthesia on Adverse Events of Cesarean Section and Prognosis of Mother and Infant in Pregnant Women with Hypertension. JOURNAL OF CLINICAL RESEARCH, 2023, 40(8): 1150-1153.
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2023, Vol. 40 
