HIỆU QUẢ DỰ PHÒNG TỤT HUYẾT ÁP CỦA CÁC LIỀU TRUYỀN TĨNH MẠCH NORADRENALIN KHÁC NHAU TRONG GÂY TÊ TỦY SỐNG ĐỂ MỔ LẤY THAI

Abstract

Objectives: This study is aimed to evaluate the effectiveness of hypotensive prophylaxis and the side effects of three different doses of noradrenaline infusion in spinal anesthesia for cesarean section. Subjects and methods: 120 full-term pregnant women with prescription for spinal anesthesia for cesarean section were randomly divided into three groups to receive three different noradrenaline infusion doses of 0,025 µg/kg/min, 0,05 µg/kg/min, and 0,075 µg/kg/min during spinal anesthesia. The primary endpoints included: rate of hypotension, hypertension, and bradycardia; incidence of nausea and vomiting, Apgar score, and umbilical artery blood gases. Results: In the groups receiving 0,05 g/kg/min and 0,075 µg/kg/min of noradrenaline, the rate of hypotension was 10%, which was significantly lower compared to the group receiving 0,025 µg/kg/min (27.5%) (p<0,05). The rate of hypertension in the 0,075 µg/kg/min dose group was 5% (n=2), but the difference was not statistically significant compared to the other two groups. The rates of bradycardia, maternal nausea and vomiting, Apgar scores after one and five minutes, and neonatal umbilical artery blood gases were similar among the three groups (p>,.05). Conclusion: Both the 0,05 µg/kg/min and 0,075 µg/kg/min noradrenalin infusion rates effectively reduced postspinal hypotension during cesarean delivery compared with the 0,025 µg/kg/min infusion rate. A dose of 0,075 µg/kg/min can cause an increase in blood pressure. There were no differences in the rates of bradycardia, nausea, and vomiting, in neonatal outcomes among the three study groups.