Abstract:

Objective  To study the effects of equivalent dose of ephedrine and phenylephrine on the prevention and treatment of post-spinal hypotension during combined spinal epidural anesthesia(CSEA) for  caesarean section,and to observe their influence in neonate and the maternal adverse reactions. Methods  40 pregnant women who had elective cesarean delivery under spinal anesthesia were randomly divided into 100 μg?L-1  phenylephrine group (n=20) and 8 mg?L-1 ephedrine group (n=20),and the blood pressure,heart rate,adverse reactions such as nausea and vomiting, umbilical venous blood gas samples，plasma concentrations of lactate and glucose,Apgar score and NABA score of neonate were recorded. Results The general state,intraoperative adverse reactions of maternal,Apgar score and NABA score after birth had no significant differences between two groups(P>0.05). The systolic blood pressure in ephedrine group after intrathecal injection for 5,10,15 and 20 mins were higher than that in phenylephrine group (P<0.05). In phenylephrine group,the umbilical venous pH,concentrations of lactate and glucose were lower than those in ephedrine group,but there were no significant differences(P>0.05). The frequency of using drugs  in phenylephrine group was higher than that  in ephedrine group,and there were significant differences (P<0.05). Conclusion  Compared with 100 μg phenylephrine,8 mg ephedrine  is also effective and safe to maternal and neonate in the prevention of post-spinal hypotension during CSEA for  caesarean section.

Key words: ephedrine;phenylephrine;combined spinal epidural anesthesia;caesarean section