Effect of Ultrasound-assisted Intraspinal Anesthesia in Caesarean Section of Obese Women with Hypertensive Disorder Complicating Pregnancy

WANG Yajuan; HUANG Shan; GONG Wei; SONG Weiwei; LYU Lin

doi:10.3969/j.issn.1002-3429.2023.07.025

Abstract：Objective To study the application effect of ultrasound-assisted intraspinal anesthesia in caesarean sec-tion of obese women with hypertensive disorder complicating pregnancy(HDCP).Methods From January 2020 to July 2022,62 obese patients with HDCP undergoing cesarean section were selected and divided into ultrasound group(n =31)and control group(n =31)according to application of ultrasound-assisted localization.The ultrasound group was treated with con-ventional combined spinal-epidural anesthesia(CSEA)under ultrasound guidance,and the control group was treated with con-ventional CSEA.The puncture condition,anesthetic effect,perianesthetic vital signs,umbilical arterial blood gas analysis in-dex and anesthesia-related complications were compared between the two groups.Results The success rate of one puncture in ultrasound group was 100.00%(31/31),which was higher than that in control group[80.65%(25/31)](P＜0.01).The pre-puncture location,epidural puncture,subarachnoid puncture,epidural catheter placement and the effective time of anesthesia in ultrasound group were shorter than those in control group(P＜0.01).The anesthesia effect rating of ultrasound group was better than that of control group(P＜0.01).The heart rate(HR),diastolic blood pressure(DBP)and systolic blood pressure(SBP)during skin incision in the two groups were higher than those before anesthesia,and DBP and SBP at the time of extraction were lower than those during skin incision(P＜0.05).The changes of HR during skin incision,DBP and SBP at the time of extraction in ultrasound group were better than those in control group(P＜0.05,P＜0.01).There was no significant difference in the blood partial pressure of carbon dioxide,blood partial pressure of oxygen and lactic acid between the two groups(P＞0.05).The incidence of puncture point and peripheral pain in ultrasound group was lower than that in control group(P＜0.01).Conclusion Ultrasound-assisted intravertebral anesthesia has a good effect on obese women with HDCP undergoing cesarean section.Ultrasound-guided positioning can promote anesthetic drugs to reach the de-sired vertebral space,shorten duration of puncture,improve the success rate of one puncture,and stabilize vital signs of preg-nant women during operation,thus reducing the incidence of anesthesia-related complications and improving surgical safety.