Abstract
INTRODUCTION:
 Hypotension is common following spinal anesthesia. Various vasopressors have been indicated to prevent it. The study compares three such agents namely phenylephrine, ephedrine and mephentermine.
 METHODS:
 The study included 90 patients undergoing elective and emergency cesarean section who developed hypotension following subarachnoid blockade. Parturient were randomly divided into three groups each group had 30 patients. Group P received bolus of Phenylephrine 25 microgram, where as group E received Ephedrine 5mg and Group M received Mephentermine 6mg.
 RESULTS:
 It was found that rise of blood pressure was significantly higher in case of phenylephrine group in first six minutes, after the bolus, there was significant reduction in the heart rate in phenylephrine group, but there was tachycardia following administration of bolus ephedrine and mephenteramine. Neonatal APGAR score were similar in all three groups.
 CONCLUSIONS:
 All three drugs maintained hemodynamics within 20 percent of the baseline values on intravenous administration.
 Keywords: APGAR, ephedrine, hypotension, mephentermine, phenylephrine, spinal anesthesia.
Highlights
During cesarean section done under spinal anesthesia, maternal hypotension is associated with dizziness, nausea, vomiting, and can cause fetal bradycardia[2] and acidosis.[3]
This study evaluates the effects of intravenous phenylephrine 25 micrograms, ephedrine 5 milligram and mephentermine 6 milligram as a vassopressor therapy in case of hypotension associated with spinal anesthesia in patients undergoing cesarean section
We found that the maternal heart rate was slower with phenylephrine than with ephedrine and mephentermine
Summary
Various vasopressors have been indicated to prevent it. The study compares three such agents namely phenylephrine, ephedrine and mephentermine. Hypotension is common following spinal anesthesia with the incidence up to 80% despite fluid preload and lateral uterine displacement.[1] During cesarean section done under spinal anesthesia, maternal hypotension is associated with dizziness, nausea, vomiting, and can cause fetal bradycardia[2] and acidosis.[3] Management of hypotension includes administration of fluids, and preemptive administration of vasopressors. In 1965, Gries and Crandell showed rapid infusion of crystalloid helped partially restore uterine blood flow.[4] But crystalloids have short half life and over infusion can cause dilutional anemia.[5] the patient may be at greater risk of pulmonary edema.[6]
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