HYPOTENSION AFTER SPINAL ANAESTHESIA;

Abstract

Objective: Aim of the study is to compare the efficacy of Ephedrine and Phenylephrine for treatment of hypotension afterspinal anaesthesia for elective caesarean section. Study design: Randomized Clinical Trial. Setting: Operation theatre Department ofAnaesthesiology, Combined Military Hospital Quetta. Duration of study: Six month from 16th Sep 2011 to 15th March 2012. Materialand Method: Seventy women undergoing LSCS for singleton pregnancy under spinal anesthesia were randomly assigned in group A andB (35 in each group). All patients preloaded with Lactated Ringer’s solution 15ml/kg body weight 10 minutes before administration ofspinal anaesthesia. Mean Arterial Pressure (MAP) was recorded before administration of spinal anaesthesia considered as Base-lineMAP and then at 1 Minute, 3 minutes & at 5 minutes after administration of spinal anaesthesia. When hypotension developed (MAP falls>20% from base line), intravenous single dose of ephedrine administered in group A patients, while in group B, Phenylephrine was given.Blood pressure was recorded after 1 minute following drug administration and up to 3 minutes at 1 minute interval. Patient handed over forprocedure after 10 minutes of spinal block. The SPSS version 13 was applied to the data. Mean and standard deviation were computed fornumerical variables like age, weight, height, systolic blood pressure, Diastolic blood pressure, and Mean Arterial pressure; whereasfrequency and percentages were employed to assess the categorical variable like efficacy. Chi-square test was used to compare theefficacy of intravenous bolus of ephedrine and phenylephrine. Statistical significance was taken at p<0.05. Results: There wassignificant difference in the efficacy of both the drugs, in the treatment of maternal hypotension. 74.29% were successfully treated ingroup “A” with a single dose of Ephedrine, as compared to group B where 51.43% were successfully treated with a single dose ofPhenylephrine. (p-value = 0.048). Conclusions: Intravenous ephedrine has more efficacy than phenylephrine in the treatment ofmaternal hypotension after spinal anesthesia for elective cesarean section.