Hemodynamic characteristics in preeclampsia women during cesarean delivery after spinal anesthesia with ropivacaine  

作　　者：Na Zhao Jin Xu Xiao-Guang Li Joseph Harold Walline Yi-Chong Li Lin Wang Guo-Sheng Zhao Ming-Jun Xu 

机构地区：[1]Department of Anesthesiology,Beijing Obstetrics and Gynecology Hospital,Capital Medical University,Beijing 100026,China [2]Department of Emergency Medicine,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences and Peking Union Medical College,Beijing 100730,China [3]Accident and Emergency Medicine Academic Unit,Prince of Wales Hospital,The Chinese University of Hong Kong,Hong Kong 9990777,China [4]Department of Clinical Research and Epidemiology,National Clinical Research Center for Cardiovascular Diseases,Fuwai Hospital,Chinese Academy of Medical Sciences,Beijing 100037,China

出　　处：《World Journal of Clinical Cases》2020年第8期1444-1453,共10页世界临床病例杂志

基　　金：the Beijing Municipal Administration of Hospitals Youth Program Grant,No.QML20161403.

摘　　要：BACKGROUND Very few studies have been published on the hemodynamic changes associated with spinal anesthesia induced with ropivacaine during cesarean deliveries in preeclamptic women.AIM To record and analyze hemodynamic data in women with preeclampsia undergoing cesarean delivery after spinal anesthesia induced with ropivacaine.METHODS Ten eligible women with preeclampsia were enrolled in this prospective observational study.Spinal anesthesia was performed with 2.4 mL of 0.5%ropivacaine.Hemodynamic changes were then analyzed at multiple time points.The hemodynamic responses to vasopressor interventions and uterotonic agents,as well as maternal and neonatal outcomes were also recorded.RESULTS Stable hemodynamic trends were observed in this study.Cardiac output(CO)and stroke volume increased mildly during surgery.In contrast,mean arterial pressure and systemic vascular resistance showed a moderate decrease from induction until the end of surgery.Central venous pressure dramatically increased after delivery.Oxytocin administration was associated with the most significant hemodynamic fluctuations during surgery,namely,an increase in CO and heart rate.Phenylephrine intervention was only required in three patients,and caused an increase in mean arterial pressure and systemic vascular resistance along with a decrease in heart rate,stroke volume,and CO.No maternal and neonatal complications were observed during this study,except transient episodes of hypotension.CONCLUSION Spinal anesthesia for caesarian delivery with ropivacaine in women with preeclampsia is linked to modest hemodynamic changes of no clinical significance in this study.Careful cardiovascular monitoring is still recommended,particularly after the delivery of the fetus or the use of oxytocin.

关 键 词：PREECLAMPSIA CESAREAN delivery Spinal ANESTHESIA Cardiac output HEMODYNAMICS 

分 类 号：R614[医药卫生—麻醉学]