Discussion
Cor, acidosis, labor, respiratory depression, hypertension, trauma
ADVERSE REACTIONS, NEONATAL RESPIRATORY DEPRESSION, INFLAMMATORY RESPONSES, CONTRACTIONS, HYPERTENSION IN PREGNANCY, ARTERIAL SPASM, ACIDOSIS, PREGNANCY INDUCED HYPERTENSION, RESPIRATORY DEPRESSION, HYPERTENSION, COMPLICATIONS
The main pathological feature of hypertension in pregnancy is systemic arterial spasm [The implementation of labor analgesia can effectively maintain the stability of the circulation during the delivery process and reduce the occurrence of related complications [Continuous epidural anesthesia is a widely used method for labor analgesia, but the dose of drugs used in this way may lead to excessive maternal absorption of drugs into the bloodstream, causing respiratory depression in the newborns, and there is also incomplete analgesic block in some cases. Continuous subarachnoid anesthesia is delivering the anesthetic drugs through a micro catheter placed into the subarachnoid space directly. Compared with continuous epidural anesthesia, the multiple advantages of continuous subarachnoid anesthesia are small dosage, accurate effect, and stabilizing circulatory system, which is an ideal anesthesia strategy for pregnant women with hypertension as the dosage of ropivacaine is reduced, significant motor nerve block is rarely occurred [The accurate hemodynamic monitoring system is also essential during the labor process [For those patients with continuous epidural analgesia, sufentanil is only used in the epidural space, the analgesic effect is not so good although the dosage is large, sufentanil can be absorbed into the blood through the venous plexus of the epidural space, increasing the risk of neonatal respiratory depression [The first stage of labor in the CSA group was longer than EA group because ropivacaine partially blocked the visceral nerves, reduced the intensity of maternal uterine contractions, and reduced the frequency of uterine contractions. There was no significant difference between the duration of the second stage of labor in the CSA group and the EA group, suggesting that the combined application of ropivacaine and sufentanil for subarachnoid analgesia had less effect on the second stage of labor. In terms of adverse reactions, the application rate of oxytocin in the CSA group was higher, but the application rate of antihypertensive drugs was significantly lower than EA group, indicating that the subarachnoid application of ropivacaine combined with sufentanil had a stronger analgesic effect. Compared with traditional epidural labor analgesia, continuous subarachnoid analgesia had no significant effect in the final delivery method. The newborns in the two groups had similar Apgar scores at 1, 5, and 10 min, and no significant respiratory depression occurred. The results of umbilical arterial blood gas analysis of newborns in both groups were all within the normal range, and there was no obvious acidosis.Previous studies have shown that both hypertension in pregnancy and normal delivery induce protective mechanisms such as stress and inflammatory responses, but overexpression of stress and inflammatory responses can impair maternal recovery. Cor is a stress-responsive hormone that is released in large amounts during trauma. In this study, the level of Cor in the CSA group at TTaken together, for pregnant women with pregnancy induced hypertension, continuous subarachnoid analgesia can improve the oxygen supply to the fetus with better analgesia effect and stable circulatory system without significant effect to the final delivery method and newborns, but it can effectively reduce stress response and inflammatory factor release of parturients therefore serves as an ideal anesthesia method for parturients with hypertension.One limitation of this study is that our study was not blinded, and the sample size included in our study is too small, and there may be some deviations in the prospective analysis; Another limitation was the anesthesia method in the study is not very commonly used clinically.