Comparing effect of Phenylephrine and ephedrine in patients undergoing lower segment caesarean section under spinal anaesthesia

Journal Title: Medpulse International Journal of Anesthesiology - Year 2017, Vol 3, Issue 1

Abstract

Background: Spinal anesthesia, a frequently used technique for caesarean delivery may be associated with maternal hypotension in as many 85% of patients. Various vasopressor have been studied for the treatment. Aim: The study was undertaken to compare the effect of phenylephrine and ephedrine in prophylactic intravenous infusion given to prevent and control intraoperative hypotension in patients undergoing lower segment caesarean section under spinal anaesthesia for ASA –PS 2014 I and II. Materials and Methods: Fifty patients were taken for this present study and distributed randomly to two groups with consent. Group A included 25 patients who were administered inj. Phenylephrine 100ugm/min infusion soon after giving spinal anaesthesia. In group B 25 patients were administered inj. Ephedrine 1mg/min as an infusion after giving spinal anaesthesia. Parameters observed were maternal heart rate, blood pressure, O2 saturation, level of block. Results: Maximum cases were in the age group of 21-25years, 56% in group A and 52% in group B belong to this age group. Maximum cases were in between the 51-55kgs group 40% in group A and 48% in group B. Spinal anaesthesia with 2ml (10mg) of 0.5% of inj. Bupivacaine was given and the level of block checked at 2 min and 5 mins. The level of anaesthesia achieved was T4 in group A (44%) and group B (56%). Inj. Phenylephrine 100ugm/min infusion was found to be superior in preventing and controlling the hypotension, as 96% of cases the fall of blood pressure was prevented and it was brought back to normal preoperative levels within 2-4minutes after giving spinal anaesthesia. In group B with inj.ephedrine 1mg/min it took a 8-10minutes for the control of blood pressure. Bradycardia was not a significant finding in ephedrine group. Conclusions: Titrated prophylactic phenylephrine infusion is preferred over ephedrine group in controlling fall of blood pressure with careful monitoring of pulse rate

Authors and Affiliations

P Savanth Kumar, G S Nikilesh Kumar

Keywords

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