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| Effect of Phenylephrine combined with Ephedrine on heart rate variability in puerpera undergoing cesarean section |
| ZHU Mei-lin ZHENG Wen-huiCHENG Li-li ZHANG Ting-ting Dong You-jing▲ |
| Department of Anesthesiology,Shengjing Hospital of China Medical University,Liaoning Province,Shenyang 110004,China |
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Abstract Objective To investigate the effect of Phenylephrine combined with Ephedrine on heart rate variability(HRV)during cesarean section in puerperae.Methods Ninety full-term single-birth puerperae in ASAⅠ-Ⅱ patients undergoing cesarean section in appropriate time from November 2016 to June 2017 in our hospital were enrolled.They were randomly divided into 3 groups according to the random number table method,with 30 cases in each group.Patients with reduced blood pressure after anesthesia(20%reduction from baseline or systolic blood pressure<90 mmHg)were treated for elevating blood pressure.The 0.15 mg/kg Ephedrine was provided in E group.And 1 μg/kg Phenylephrine was used in P group.In E+P group,Ephedrine(0.1 mg/kg)and Phenylephrine(0.5 μg/kg)were combined used.The HRV low frequency(LF),HRV high frequency(HF),and LF/HF were recorded before anesthesia(T0),1 min after injection into the subarachnoid space (T1),and at the lowest blood pressure using drugs for elevating blood pressure(T2),and 3 min(T3),5 min(T4),and 10 min(T5)after medication.By paired t-test,the indexes at T3-T5were compared with those at T0in order to determine whether there was a statistical difference.Results The values of LF and LF/HF at T1-T5time points in the E group were significantly higher than those at T0,and HF was significantly lower than T0,the differences were statistically significant(P<0.05).In the P group,the values of LF and LF/HF at T1-T3time points were much lower than those at T0and HF were greatly higher than T0,which was displayed statistical significance (P<0.05).In the P group,there was no sig-nificant difference in the values of LF,HF and LF/HF at T4and T5time points in the P group compared with T0(P>0.05).No significant difference in the values of LF,HF and LF/HF at T3-T5time points compared with T0in the E+P group (P>0.05).The LF and LF/HF at T3and T4time points in the E group were greatly higher than those in the E+P group,HF was significantly lower than that in the E+P group,and the differences were statistically significant(P<0.05).The LF at T5time points in the E group was greatly higher than that in the E+P group,HF was significantly lower than that in the E+P group,and the differences were statistically significant(P<0.05).The LF and LF/HF at T3time points in the P group were greatly higher than that in the E+P group,HF was significantly lower than that in the E+P group,and the differences were statistically significant(P<0.05).Conclusion For puerperae undergoing cesarean section,Phenylephrine combined with Ephedrine can maintain autonomic sympathetic/vagal balance and keep LF,HF,and LF/HF in normal conditions,which is beneficial to the HRV stability.
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