Maternal Hemodynamic and Neonatal Outcome in Preeclamptic Parturients Udergoing Cesarean Section with Small Dose Bupivacaine-Sufentanyl Spinal Anesthesia

摘要

We studied both markers of neonatal condition and maternal hemodynamic in preeclamptic patients receiving spinal anesthesia for cesarean section. Forty four preeclamptic patients were randomized to two groups of 22 patients in this double-blind and case-controlled trial study. Group A received a spinal anesthetic of bupivacaine 6 mg plus sufentanyl 3.3 ?g and Group B received 12 mg bupivacaine. Hypotension was defined as a 30% decrease in systolic and diastolic pressure from baseline. Hypotension was treated with intravenous ephedrine boluses 2/5-5 mg up to maximum 50 mg. After delivery, neonatal 1st and 5th apgar scores were evaluated and umbilical arterial blood gas samples were taken and analyzed. All patients had satisfactory anesthesia. About 5 of 22 patients in group A required ephedrine, a single dose of 5 mg. About 17 of 22 patients in group B required vasopressor support of blood pressure. First and 5th apgar scores (p = 0.760, 0.349) and umbilical arterial blood gas markers (PH, PCO2, HCO3, BE) showed no deference between 2 groups (p>0.05). A small-dose of 6 mg bupivacaine in combination with 3.3 ?g sufentanyl provides satisfactory spinal anesthesia for cesarean section in the preeclamptic patients and caused dramatically less hypotension than 12 mg bupivacaine. Also, neonatal apgar score and umbilical arterial blood markers are not influenced it.