SO SÁNH MỘT SỐ TÁC DỤNG KHÔNG MONG MUỐN CỦA PHƯƠNG PHÁP GÂY TÊ TỦY SỐNG - NGOÀI MÀNG CỨNG PHỐI HỢP VỚI GÂY TÊ TỦY SỐNG ĐƠN THUẦN ĐỂ MỔ LẤY THAI TRÊN SẢN PHỤ CÓ NGUY CƠ CAO TỤT HUYẾT ÁP

Abstract

Objective: To compare  the side effects of combined spinal epidural anesthesia versus spinal anesthesia for cesarean section in pregnant women with high risk of hypotension. Methods: 60 pregnant women with high risk of hypotension (polyhydramnios, macrosomia or twins) underwent elective cesarean delivery were enrolled into this prospective, randomized, double-blind study. Patients were randomly divided into spinal anesthesia group (Group I) or combined spinal – epidural anaesthesia – CSE group (Group II). Group I received bupivacaine either 7 mg, 8 mg or 8,5 mg bupivacaine depending on the heigh of patients (<150cm, 150 – 160 cm, >160cm) with fentanyl 30mcg ; Group II received bupivacaine 5 mg with fentanyl 30mcg followed by epidural 1% lidocaine 10 mL with adrenaline 1:200 000. The side effects were recorded during the surgery and 48 hours after surgery. Results: The rate of vomiting and nausea was 6.67% in CSE group and was 23.3% in the spinal anesthesia group (p <0.05). The rates of pruritus and chills in the group of combined spinal-epidural anesthesia group were 23.3% and 13.3% compared with 26.6% and 26.6% in spinal anesthesia group. No patient suffered from respiratory distress, deep sedation, headache, and urinary retention in both groups. The infants' 1st and 5th minute Apgar scores in both groups were > 8, no significant difference). No dangerous complication of mothers and newborns was recognized. Conclusions: The rate of vomiting and nausea in CSE group was lower than in spinal anesthesia group, p < 0.05. Other side effects on mothers and newborns did not differ between the two groups. No dangerous complication on mothers and newborns was recognized.