Effect of combined spinal epidural anesthesia with different doses of ropivacaine on maternal and child RAAS system in cesarean section
10.3760/cma.j.issn.1008-6706.2019.11.020
- VernacularTitle: 不同剂量罗哌卡因等比重腰麻-硬膜外联合阻滞对母婴肾素活性、血管紧张素Ⅱ及醛固酮系统的影响
- Author:
Zhonghua XIONG
1
;
Daihui LI
Author Information
1. Department of Anesthesiology, the Maternal and Child Health Hospital of Anji County, Zhejiang 313300, China
- Publication Type:Journal Article
- Keywords:
Cesarean section;
Ropivacaine;
Renin-angiotensin system;
Aldosterone;
Anaesthesia, union
- From:
Chinese Journal of Primary Medicine and Pharmacy
2019;26(11):1364-1367
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the impact of different doses of ropivacaine combined with spinal epidural anesthesia for maternal and neonatal renin activity, angiotensin II and aldosterone in the cesarean section system.
Methods:From June 2015 to April 2017, 140 parturients undergoing cesarean section in the Maternal and Child Health Hospital of Anji County were selected in the research.Combined spinal-epidural ropivacaine were used in all patients during cesarean section anesthesia, and according to different dose of ropivacaine, the patients were divided into A group (8mg), B group(10mg), C group(12mg), D group(15mg), with 35 cases in each group.The analgesic effects of four groups and the changes of each index in the RAAS system of mother and baby in each time period were compared.
Results:All fetuses were delivered smoothly.Compared the analgesic effect of four groups, the analgesic effect of IV grade in A group was the lowest percentage [17.14%(6/35)], B, C group had similar proportions [42.86%(15/35), 45.71%(16/35)], D group had the highest proportion [71.42%(25/35)], the maternal proportion of anesthesia effect of IV grade in D group was significantly better than those in A, B, C group, and the differences were statistically significant(χ2=20.90, 5.83, 4.77, all P<0.05). There was no significant change in the level of PRA in each period of A group.The PRA levels in B, C and D group at T1-T3 time were significantly lower than T0(t=14.64, 37.04, 3.97; 15.34, 29.93, 4.73; 25.83, 33, 5.23; 12.47, 8.94, 5.96, all P< 0.05). AT-II in A group at T1-T3 time was decreased, but there was no statistically significant difference compared with T0.AT-II levels in B, C, D group at T1-T3 time were significantly lower than that of T0(t=5.95, 5.98, 3.19; 5.86, 5.54, 4.77; 7.96, 5.47, 6.13; all P<0.05). No significant changes in ALD level of A group in every period of time; ALD levels in B, C, D group at T1-T3 time period were significantly lower than that of T0(t=3.75, 4.92, 2.47; 4.08, 5.77, 2.05; 3.94, 6.13, 3.55, all P<0.05). The fetal umbilical artery and vein of PRA, AT-II and ALD concentration were measured in maternal value range.
Conclusion:When combined with 10-15 mg ropivacaine for combined spinal epidural anesthesia, the RAAS system of mother and baby is more stable, and the effect of anesthesia and analgesia is better.
