Effect of uterus traction on hemodynamics and plasma TXA_2, PGI_2 levels during operation under continuous spinal anesthesia / 中华麻醉学杂志

ABSTRACT

Objective To determine the changes in hemodynamics and plasma PGI2, TXA2 levels caused by uterus traction during operation under continuous spinal anesthesia. Methods Thirty ASA Ⅰ -Ⅱpatients undergoing hysterectomy under continuous spinal anesthesia (CSA) were studied. Aged ranged from 28 to 65 years, height from 150-171 cm and body weight 40-72kg. The patients were premedicated with intramuscular phenobarbital sodium 0.1g and atropine 0.5mg 30 min before surgery. Continuous spinal anesthesia (CSA) was performed at L2-3 with 22G Spinocath ( Braun) . Hyperbaric bupivacaine 0.5% (0.75 % bupivacaine 4ml+ 10 % glucose 2ml) was injected and the height of block was maintained at T8 . Venous blood samples were taken before anesthesia (T0 ), before skin incision ( T1 ), before traction on uterus (T2 ), uterus was being pulled for 10min (T3 ) and 15 min after the end of surgery (T4 ) for determination of 6-keto-PGF1** and TXB2 . BP, HR, SpO2 and ECG were continuously monitored during surgery. Results Continuous spinal anesthesia provided perfect analgesia and satisfactory muscle relaxation. MAP and HR decreased significantly when uterus was pulled (P