Changes in parameters of hemodynamics in abdominal delivery with different methods of anesthesia
DOI:
https://doi.org/10.15587/2519-4798.2020.193841Keywords:
caesarean section, central and peripheral hemodynamics, general anesthesia, spinal anesthesia, hemodynamic types of circulation, risk, arterial hypotensionAbstract
Aim. To study and evaluate changes in the basic parameters of central and peripheral hemodynamics of the maternal organs in caesarean section (CS) with different methods of anesthesia.
Materials and methods. 127 pregnant women were divided into 4 subgroups: Ia (n=31) – general anesthesia (GA) using Ketamine, Ib (n=31) – GA with Sodium Thiopental, IIa (n=31) – spinal anesthesia (SA), IIb (n=34) – SA with Ondansetron 8 mg intravenous. The assessment was performed in 5 stages: 1 – initial; 2 – beginning of operation; 3 – fetal extraction; 4 – end of operation; 5 – 12 hours after operation. The main indicators of hemodynamics were analyzed: systolic (SAP), diastolic (DAP) and mean (MAP) arterial pressure, stroke volume of the heart (SV), cardiac output (CO), cardiac index (CI), total peripheral vascular resistance (TPR).
Results. Maximum increase of SAP, DAP, MAP, CI, CO in GA groups was found at the prenatal stage. Decrease of SAP, DAP, MAP in SA groups was indicated. Hypotension in IIa subgroup required correction with Mesatone in 23 women, while only five patients from IIb subgroup had a correction of hypotension with Mesatone.
Conclusion. In subgroups Ia and Ib, major hemodynamic changes were noted at the prenatal stage, which is manifested in energetically less favorable functioning of the cardiovascular system. CS with SA using Ondansetron was accompanied by favorable hemodynamic shifts at all the stages (especially at the prenatal stage), what is indicating "hemodynamic safety" of that method of anesthesia
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