Effect of subarachnoid anesthesia combined with epidural volume extension on cesarean section

Wang Yafeng; Ma Li; Lan Yuyan; Zhu Weilin; Luo Chao; Bao Yanli; Gan Lixia

doi:10.3760/cma.j.issn.1673-4777.2017.03.022

Abstract：Objective To analyze the effect of subarachnoid anesthesia combined with epidural volume extension on cesarean section.Methods Eighty pregnant women scheduled for cesarean section (American Society of Anesthesiologists grade Ⅰ-Ⅱ) in the People's Hospital of Guangxi Zhuang Autonomous Region from January to November 2015 were randomly divided into group A and group B,with 40 cases in each group.Group A had subarachnoid anesthesia with 0.5％ ropivacaine 10 mg and fentanyl 10 μg;group B had subarachnoid anesthesia with 0.5％ ropivacaine 7.5 mg and fentanyl 10 μg,5 min later had epidural volume extension with 0.9％ sodium chloride 10 ml.Operation time,the highest sensory block level,time to the highest sensory block level,time of sensory block regressing to T10,the lowest systolic blood pressure,intraoperative score of visual analog scale(VAS),postoperative time to pain treatment,dose of ephedrine,time to maximum Bromage score,time of Bromage score recovering to zero and occurrence of adverse reactions were analyzed.Results The time to maxium Bromage score and the time of Bramage score recovering to zero in group B were significantly shorter than those in group A [(4.5 ± 1.2) min vs (5.7 ± 2.3) min,(121 ± 20) min vs (142 ± 30) min] (P ＜ 0.05).The other indicators had no significant differences between groups (P ＞ 0.05).Incidences of hypotension,bradycardia,nausea,vomiting and shivering had no significant differences between groups (P ＞ 0.05).Conclusion Single shot subarachnoid anesthesia with low dose of ropivacaine in combination with 10 ml 0.9％ sodium chloride epidural volume extension achieves rapid and exact anesthesia for cesarean section and shortens time of motor block.