Effect of continuous spinal anesthesia on the hemodynamics of labor analgesia in hypertensive pregnant women: a randomized clinical trial

Abstract

Abstract Background: To evaluate whether the LiDCO-rapid monitor had any advantages compared to continuous epidural analgesia to bring beneficial for hypertensive pregnant women and their newborns. Methods: In total 160 parturients with hypertensive disorder complicating pregnancy were enrolled and randomly divided into continuous spinal analgesia group (CSA) and continuous epidural analgesia group (EA). The LiDCO-rapid system was used to monitor the hemodynamic changes of all participants. The inflammatory factors and stress response hormones were measured in the participants' serum. Results: The first stage of labor in CSA was longer than EA (P < 0.05); the MAP, VAS and SVR value in CSA were lower than EA group at T1, T3 and T4 (P < 0.05); in contrast, the CO in CSA at T3 and T4 was higher than in EA (P < 0.05). The oxytocin was more often used whereas the antihypertensive drugs were less used in CSA as compared to EA. The level of TNF-α, IL-6, Cor in the CSA at T5 was lower than the EA group (P < 0.05), and the level of TNF-α in the CSA group at T7 was lower than the EA group (P < 0.05). Conclusion: For pregnant women with hypertension during pregnancy, continuous spinal analgesia can improve the oxygen supply of the fetus. Since the advantageous effect is definite and circulatory system is stable, it is recommended to implement continuous spinal analgesia early in the labor process, which can effectively decrease stress response and inflammatory factors that having benefits for both parturient and fetus. Trial registration: ChiCTR-INR-17012659 Date of registration: 13/09/2017