Effect of Combined Spinal-Epidural Anesthesia and Total Intravenous Anesthesia on Hemodynamics and Pregnancy Outcomes of Severe Preeclampsia Pregnant Patients Undergoing Cesarean Section

OBJECTIVE: The purpose of the study was to investigate the effect of combined spinal-epidural anesthesia (CSEA) and total intravenous anesthesia (TIVA) on hemodynamics and pregnancy outcomes of severe preeclampsia pregnant patients undergoing cesarean section. METHODS: 126 patients with severe preeclampsia admitted to Zhangqiu District People's Hospital from August 2018 to August 2019 were selected as the study subjects and randomly divided into the experimental group (n = 63) and control group (n = 63). After undergoing cesarean section, the patients in the experimental group received CSEA, while those in the control group were given TIVA. After that, the effect of different anesthesia methods on the hemodynamics and pregnancy outcomes of pregnant women was compared. RESULTS: There were no significant differences in age, BMI value, weight, height, gestational weeks, SBP, DBP, and residence between the two groups (P > 0.05). The operation duration, the onset time of anesthesia, and delivery time in the experimental group were significantly shorter than those in the control group, with less intraoperative blood loss in the experimental group than that in the control group (P < 0.001). In both groups, MAP and SpO(2) during delivery were significantly lower than those before anesthesia, and HR was significantly higher than that before anesthesia (P < 0.001). In the experimental group, MAP and HR during delivery were significantly lower than those in the control group, and SpO(2) was significantly higher than that in the control group (P < 0.001). The total effective rate of anesthesia in the experimental group was significantly higher than that in the control group (P < 0.05). The Apgar scoring of the newborns in the experimental group was significantly higher than that in the control group (P < 0.001), and the total incidence of postoperative adverse reactions in the experimental group was significantly lower than that in the control group (P < 0.05). CONCLUSION: CSEA is a reliable anesthesia method for improving the hemodynamics indicators in pregnant patients with severe preeclampsia; such strategy greatly increases the Apgar score of newborns and shortens the anesthesia onset time. Further research will be conducive to establishing a better anesthesia plan for such patients.