Clinical observation of the effect of pre-pumping norepinephrine on hemodynamics of cesarean section parturients under combined spinal-epidural anesthesia

ObjectiveTo observe the effect of pre-pumping norepinephrine on hemodynamics of cesarean section patients under combined spinal-epidural anesthesia.

MethodsSixty ASA Ⅰ-Ⅱ patients with elective cesarean section after combined spinal-epidural anesthesia were randomly divided into the observation group and control group, with 30 cases in each group.All patients were infused with mL/kg hydroxyethyl starch 30 min before anesthesia.At the beginning of combined spinal-epidural anesthesia, the patients in the control group were continuously pumped with 0.75 mL·kg^-1·h^-1 of 0.9% sodium chloride solution, and the patients in the observation group were continuously pumped with 0.75 mL·kg^-1·h^-1 (0.05 μg·kg^-1·min^-1) of noradrenaline until delivery of the fetus.The mean arterial pressure (MAP), heart rate (HR), 1 min and 5 min Apgar score of neonate, and adverse reactions were compared between the two groups at the time of admission (T₀), after volume expansion (T₁), 1 min after anesthesia (T₂), 3 min after anesthesia (T₃), at the time of fetal delivery (T₄), and at the end of operation (T₅).

ResultsThere was no significant difference in operation time, anesthesia time and bleeding volume between the two groups (P>0.05).There was no significant difference in MAP and HR between the two groups at T₀ (P>0.05);the MAP in the observation group at T₂ was higher than that in the control group (P < 0.05), and the HR at T₂ and T₃ was lower than that in the control group (P < 0.01 and P < 0.05);compared with T₀, the MAP in the control group decreased after anesthesia, but the difference was not statistically significant (P>0.05), and the HR increased at T₂ and T₃ (P < 0.05);there was no significant difference in MAP and HR between each time point and T₀ in the observation group (P>0.05).There was no significant difference in the incidence of hypotension, hypertension, nausea and vomiting, and bradycardia between the two groups (P>0.05).There was no significant difference in 1 min and 5 min Apgar score between the two groups (P>0.05).

ConclusionsPre-pumping 0.05 μg·kg^-1·min^-1norepinephrine before anesthesia can stabilize the maternal hemodynamics, and has no effect on the neonate, which can improve the safety of the mother and baby in cesarean section.