Comparison of different puncture positions for combined spinal-epidural anesthesia in cesarean section / 临床麻醉学杂志

ABSTRACT

Objective To compare the effect of different puncture positions in the combined spinal epidural anesthesia (CSEA)in cesarean section.Methods Ninety uterogestation women under-going elective Caesarean section were randomly divided into two groups,45 in each group.L3-4 inter-vertebral space was selected as puncture point.Group R kept right lateral position for two minutes af-ter puncture and turned 30°left tilt supine position until ready for surgery.Group L was turned to su-pine position after left lateral punctured and then turned to 30 left tilt supine position until ready for surgery.1% ropivacaine 1.5 ml+ 10% glucose 0.5 ml was used for spinal anesthesia.The sensory block level and adverse reaction within 1 5 min after the spinal anesthesia were observed,and the neo-natal Apgar score and the pH value of umbilical artery blood were recorded.Results The final block level of the group R was significantly lower than group L,and the time achieving final block height was significantly shorter than that in group L(P <0.05 ).The ephedrine dosage of group R 0 (0-6) mg was significantly lower than that of group L6 (0-12)mg (P <0.05).The PH value of umbilical artery blood in group R was significantly higher than that in group L (P <0.05).There was no sig-nificant difference in neonatal Apgar score.Conclusion In Cesarean section,keeping right lateral puncture position for two minutes after infusion and then turning 30° left tilt supine position can a-chieve better effects than 30°left tilt supine position immediately after puncturing.