SO SÁNH HIỆU QUẢ DỰ PHÒNG VÀ ĐIỀU TRỊ TỤT HUYẾT ÁP SAU TÊ TỦY SỐNG MỔ LẤY THAI CỦA NORDRENALINE TRUYỀN TĨNH MẠCH LIÊN TỤC VỚI TIÊM TĨNH MẠCH NGẮT QUÃNG

Abstract

Objectives: To compare the effectiveness of the prevention and treatment of hypotension of continuous intravenous infusion with intermittent intravenous noradrenaline in spinal anesthesia for cesarean section. Methods: Prospective, randomized, comparative clinical trial. 120 patients who received spinal anesthesia for cesarean section were randomly assigned to 2 equal groups. Procedure: both groups received crystalloid infusion before spinal anesthesia at a dose of 10 ml/kg. Spinal anesthesia at the L2-3 vertebral interspace. Bupivacaine dose according to height (7.5mg-8.5mg). Group I: received a continuous infusion of noradrenaline at a dose of 0.05 mcg/kg/min after spinal anesthesia and increase or decrease range 0-60 ml. In group II: was given a prophylactic dose of 5mcg/ml after spinal anesthesia and both groups had treated for hypotension at 1 ml (5 mcg/ml) 1 min apart until blood pressure returned to normal.  We had finished the oxytoxin infusion when we stopped the continuous infusion. Evaluation: changes in blood pressure, noradrenaline dose, fluid parameters. Results: Blood pressure of group I was higher than that of group II at T3, T4 and T9. Total (mcg) noradrenaline of group I (44,7 ± 12,8 mcg) was more than group II (11,1 ± 7,8 mcg). The number of patients receiving bolus injection in group I (11.7%) was less than in group II (43.3%).  The amount of crystalloid fluid after spinal anesthesia of group I (568.8 ± 136.6 ml) was used less than that of group II (660 ± 178.9 ml). The number of patients requiring colloidal infusion in group I (6.7%) was less than in group II (21.7%) with statistical significance. Conclusion: The preventive effect of Noradrenaline infusion was better than intermittent injection and treatment was given bolus doses, fluid infusion with less than intermittent injections.