Abstract
Background and Aims: During Cesarean section, hypotension occurs in the most of parturients, following spinal anesthesia. This prospective observational study was undertaken to determine the efficacy of two different Bolus Doses of Phenylephrine for Prevention of Spinal-Induced Hypotension during Cesarean Section.
 Materials and Methods: A total of 120 parturients undergoing cesarean section were divided into two groups of group A and group B with sixty in each group. Group A received phenylephrine 75 mcg IV bolus, while Group B received phenylephrine 100 mcg IV bolus, immediately after giving spinal anesthesia. For the next 20 minutes, systolic blood pressure (SBP), diastolic blood pressure (DSP), mean arterial pressure (MAP), and heart rate (HR) were recorded every 2 minutes, and APGAR scores at 1 and 5 minutes were recorded.
 Results: There was no difference between the two groups in terms of preventing hypotension, with 16.6% in Group A and 16.6% in Group B. In the first 2–6 minutes, however, the rise in systolic pressure in Group B was higher than in Group A. Group B (46.66 %) had a higher rate of bradycardia than Group A (25 %).
 Conclusion: Both phenylephrine dosages were equally effective in preventing hypotension following spinal anesthesia. However, Prophylactic bolus dose of phenylephrine 75 mcg was found to be effective for the management of spinal-induced hypotension and should be preferred over 100 mcg which causes significant bradycardia and reactive hypertension.
Highlights
Prophylactic bolus dose of phenylephrine 75 mcg was found to be effective for the management of spinal-induced hypotension and should be preferred over 100 mcg which causes significant bradycardia and reactive hypertension
As indicated in [Table 2], the changes in mean Diastolic Blood Pressure (DBP) in Group A and Group B following spinal anesthesia were in the range of 72.91 - 60.92 mm Hg and 84.68 - 63.06 mm Hg, respectively
As indicated in [Table 3], the changes in mean of mean arterial pressure (MAP) in Group A and Group B following spinal anesthesia were in the range of 91.96 - 78.68 mm Hg and 102.35 - 79.89 mm Hg, respectively
Summary
Low dosage of phenylephrine 20 mcg as determined to be not effective, high doses of around 100 mcg resulted in baroreceptor mediated maternal bradycardia with a consequent reduction in maternal cardiac output [4]. The goal was to determine the dose of phenylephrine that would maintain hemodynamic stability while without compromising cardiac output. This randomized study was undertaken to determine the efficacy of two different Bolus Doses of Phenylephrine for Prevention of Spinal-Induced hypotension during Cesarean Section. During Cesarean section, hypotension occurs in the most of parturients, following spinal anesthesia This prospective observational study was undertaken to determine the efficacy of two different Bolus Doses of Phenylephrine for Prevention of Spinal-Induced Hypotension during Cesarean Section.
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