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KMID : 0377619970620090775
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Korean Jungang Medical Journal
1997 Volume.62 No. 9 p.775 ~ p.775
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The effect of epidural anaesthesia for caesarean section on maternal uterine and fetal umbilical artery blood flow velocity waveforms
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Lee, Keun Young
Kang, Jeong Bae/Huh, Jin Suck/Kim, Hong Bae/Won, Im Su/Kang, Sung Won
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Abstract
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Objective : To study the effects of maternal epidural anesthesia on the maternal uterine circulation and the fetal umbilical placental circulation using Doppler ultrasound techniques.
Study design : Twenty-seven patients delivered by elective caesarean section under lumbar epidural anesthesia were studied. All had a normal pregnancy with no indication of fetal compromise and no indication of maternal disease. Followed by 1 liter pre-load infusion of Hartmann´s solution given over 20--30 min, the uterine and fetal umbilical artery velocity waveforms were recorded. And then intravenous cannula and an epidural catheter were inserted. The local an aesthetic agent was then injected through the epidural catheter(0.5 % bupivacaine 10 ml, 20% lidocaine l0ml). At achieve sensory blockade to the T-4 level after the injection of the anesthetic agent, the uterine and fetal placental circulation flow velocity-time waveforms were recorded using Doppler ultrasound(Multigon 50° A, 4 il:IHz). Significance was tested by means of the paired student t-test.
Results : 1. Significant differences were observed between the two groups(At pre anesthesia, S/D ratio of fetal umbilical artery is 2.48±0.50. After anesthesia, S/D ratio of fetal umbilical artery is 2.24±0.40, p<0.005).
2. Significant differences were observed between the two groups(At pre-anesthesia, S/D ratio of maternal uterine artery is 2.29±0.41. After anesthesia, S/D ratio of maternal uterine artery is 1.95±0.25, p<0.001).
Conclusion : This study suggests a beneficial effect from the improved maternal uterine perfusion after epidural anesthesia.
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