Incidence of complications after prophylactic phenylephrine and placebo in elective urological surgeries
Journal Title: Medpulse International Journal of Anesthesiology - Year 2019, Vol 10, Issue 2
Abstract
Background: Spinal anesthesia is commonly practiced neuraxial anesthesia for various surgeries including gynecological, obstetrics, urological, orthopedics, etc. The most common impediments to the effective use of neuraxial blocks are the predictable decreases in arterial blood pressure and heart rate through the accompanying sympathectomy with its attendant vasodilation and blockade of cardioaccelerator fibers. Maintaining arterial blood pressure and heart rate at normal values during these blocks often requires the administration of vasoactive drugs and intravenous fluids. The most common complication of this anesthetic technique is hypotension, with a particularly frequent incidence in the elderly. Aim and objectives: To study the Incidence of complications after prophylactic phenylephrine and Placebo in Elective Urological Surgeries for prevention of hypotension. Materials and method: The present randomized controlled, double blind study was conducted in the department of anaesthesia of tertiary care institute to study complications after prophylactic phenylephrine and Placebo used for prevention of post Sub Arachnoid Block hypotensive response in patients undergoing elective urological surgeries under Sub Arachnoid Block” Total 60 patients were enrolled in the present study and were divided in to two groups conationg 30 patients each. A computer generated randomized plan was made, which placed patients randomly in the two groups. Group P (Phenylephrine group) and Group C (Control group). The group P Patients received phenylephrine(2mg i.m.) preoperatively. After preloading pulse rate, systolic and diastolic blood pressure were recorded. The same parameters were recorded at following intervals; just prior to administration of inj phenylephrine (baseline), after subarachnoid block, every 2 min for 15 min and thereafter every 5 min till the end of the surgery. The collected data was recorded in excel sheet and was analysed with appropriate tests. A value of P<0.05 was considered statistically significant. Results: Both the groups were similar in age, ASA status, sex distribution and baseline hemodynamic variables. Hypotension was observed in 3.33% patients in group P while in 43.33% patients in group C and the difference observed statistically significant. Other than hypotension nausea was the other most common complication observed in group C patients. The percentage decreases in HR in the two groups were not significantly different. The lowest HR value in all groups was <50 bpm, and equal percent of patient in each group developed bradycardia and required medication after spinal anesthesia. Only one patient in the group P required nicardipine because of hypertension after the study medication. No patient in the other group developed hypertension. Conclusion: Based on the findings of the present study, we conclude that use of phenylephrine before sub arachnoid block causes less incidence of post sub arachnoid block hypotension and complications associated with it like nayusea, vomiting.
Authors and Affiliations
Meghna Maheshwari, Kashish Ahuja
Keywords
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- EP ID EP589662
- DOI 10.26611/10151026
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