TO COMPARE THE NEED FOR INTRAVENOUS VASOPRESSOR (RESCUE) THERAPY FOR TREATING SPINAL ANAESTHESIA INDUCED HYPOTENSION AMONG PHENYLEPHRINE, EPHEDRINE AND CONTROL GROUPS.

Bhanu Choudhary,Kunwar Singh Thakur,Preeti Goyal,Utsav Sharma

doi:10.32553/ijmbs.v4i5.1135

Bhanu Choudhary, Kunwar Singh Thakur + Show 2 more

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https://doi.org/10.32553/ijmbs.v4i5.1135

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Abstract

The study was undertaken in the Department of Anaesthesiology, Gajra Raja Medical College, Gwalior. The study included 90 patients (age 20-35 years) undergoing elective caesarean section under spinal anaesthesia. Maximum hypotension was observed in control group. As compared to the control group, incidence of hypotension was significantly less in phenylephrine group as well as ephedrine group. Also comparing ephedrine and phenylephrine groups, although incidence of hypotension was low in phenylephrine group but it was not found to be significant. The incidence of hypotension was significantly low in phenylephrine group (p=0.000) and ephedrine group (p=0.005). But when phenylephrine and ephedrine groups were compared, although incidence of hypotension was low in phenylephrine group but it was not found to be significant (p=0.869). Keywords: Intravenous Vasopressor, Spinal Anaesthesia, Hypotension & Phenylephrine.

Highlights

Hypotension is associated with distressing symptoms of dizziness, nausea and vomiting, and may interfere with the surgical procedure[1]
Comparing ephedrine and phenylephrine groups, incidence of hypotension was low in phenylephrine group but it was not found to be significant
Comparing the incidence of hypotension in phenylephrine group and ephedrine group, incidence of hypotension was low in phenylephrine group but it was not found to be significant. (p=0.351)

Summary

Introduction

Hypotension is associated with distressing symptoms of dizziness, nausea and vomiting, and may interfere with the surgical procedure[1]. Hypotension should be prevented in patients receiving spinal anaesthesia[2]. Various drugs and methods like preloading with intravenous fluids (crystalloids/colloids), ephedrine, mephentermine and even intrathecal ketamine had been studied to prevent hypotension during spinal anaesthesia with varying success. The management of choice, if hypotension occurs is the use of vasopressors as required. The usual approach to the use of vasopressors in this clinical setting is reactive rather than proactive; spinal anaesthesia induced hypotension is allowed to develop and is treated . Intramuscular (IM) ephedrine 37.5 mg has been found to be associated with a persistently high incidence of hypotension[4]. IM phenylephrine for the prevention of hypotension has been safely given to healthy volunteers, including the elderly, in doses of 0.15 mg/kg (up to 10 mg)[6,7]

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