Regional anesthesia, including epidural, spinal and combined epidural spinal anesthesia (CSEA), is a pivotal part in modern anesthesiology. Previously, the investigators found that epidural and spinal anesthesia during cesarean section possesses different responsiveness to fluid (including crystalloid and colloid) management given prior or posterior to anesthesia. Although CSEA is also widely used as an alternative of single epidural or spinal anesthesia for its combined effect of fast onset of anesthesia of spinal anesthesia and the property of duration of epidural catheterization, the fluid resuscitation during CSEA is still unknown. The investigators hypothesized that fluid management during CSEA would produce different effect on hemodynamics in cesarean section compared with epidural and spinal anesthesia.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
SUPPORTIVE_CARE
Masking
NONE
Enrollment
850
Ringer's Lactate 8 ml/kg was given intravenously before or after CSEA in cesarean section
Hydroxyethyl starch (6%) was given before or after CSEA in cesarean section
The Affiliated Nanjing Maternity and Child Health Care Hospital
Nanjing, Jiangsu, China
Rate of hypotension
Time frame: Anesthesia begin (0 min) to 120 min after anesthesia
Recurrence of hypotension after ephedrine or phenylephrine
Time frame: Anesthesia begin (0 min) to 120 min after anesthesia
Consumption of ephedrine and phenylephrine
Time frame: Anesthesia begin (0 min) to 120 min after anesthesia
Total volume of colloid or crystalloid
Time frame: Fifteen minutes before anesthesia to 120 min after anesthesia
One-min and 5-min Apgar scores
Time frame: The first and fifth minute after cesarean successful delivery
Oxygen saturation during hypotension
Time frame: Anesthesia begin (0 min) to 120 min after anesthesia
Duration of hypotension
Time frame: Anesthesia begin (0 min) to 120 min after anesthesia
Low umbilical cord pH (artery < 7.20)
Time frame: At the time of successful delivery (0 min)
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