BACKGROUND:The purpose of this study was to compare maternal and fetal haemodynamic changes, and umbilical artery pH in subjects allocated randomly to receive phenyl epherine or ephedrine for treatment of hypotension during spinal anesthesia for elective caesarean section Two hundred patient were randomly allocated into two equal groups : Group A : receive phenylephrine (1 ml). 100µg Group B : receive ephedrine (1 ml) 6 mg
METHODS: Two hundred patient were randomly allocated into two equal groups : Group A : receive phenylephrine (1 ml). 100µg Group B : receive ephedrine (1 ml) 6 mg After spinal Anesthesia and hypotension all patients were placed supine with left uterine displacement standard monitors like non-invasive BP (blood pressure), ECG and pulse oximeter were applied. Base line heart rate, systolic BP and diastolic BP were calculated as mean of three successive readings measured one minute apart. An 18 gauge I/V line taken and all patients were preloaded with 10 ml/kg lactated Ringer’s solution over 10 min then infusion rate was reduced to keep vein open.Lumbar puncture done in sitting position at L 3-4 interspace with 25 gauges Quincke needle. In every patient after confirming the free flow of CSF, 2ml (10mg) of 0.5% hyperbaric bupivacaine injected intrathecally. Patients were then immediately placed supine with 15 degree left lateral tilt position using wedge under right hip. All patients were given supplemental oxygen at 5 lit.min-1 via facemask. After SA heart rate, systolic and diastolic blood pressures were recorded at two minute interval until end of the procedure.
RESULTS: Two hundred and ninety eight parturient scheduled for cesarean delivery, fulfilling the inclusion and exclusion criteria were enrolled in this study. Hypotension occurred in 67.11 % parturient. Ninety-eight parturient who did not develop hypotension were excluded from the study. So total of two hundred parturient were included in the study and divided into two groups of 100 patients in each group Ninety two percent patients of Group A required 100 µg of phenylephrine while seventy eight percent patients of Group B required 6 mg ephedrine to treat hypotension, which was statistically significant (p=0.0009). Eight percent patients in the Group A (phenylephrine) and twenty two percent patients in Group B (ephedrine) needed second dose of vasopressor to maintain systolic blood pressure
CONCLUSION: Intravenous bolus doses of phenylephrine 100 µg and ephedrine 6 mg were both effective in treating hypotension after SA for elective cesarean section. Phenylephrine was comparatively more effective because less bolus doses were required to treat hypotension than ephedrine. Mean Apgar scores of the neonates at 1 and 5 min were comparable between the two groups.
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