HYPOTENSION AFTER SPINAL ANAESTHESIA;

EFFICACY OF EPHEDRINE AND PHENYLEPHRINE FOR TREATMENT DURING ELECTIVE CAESAREAN SECTION

Abstract

Objective: Aim of the study is to compare the efficacy of Ephedrine and Phenylephrine for treatment of hypotension after
spinal anaesthesia for elective caesarean section. Study design: Randomized Clinical Trial. Setting: Operation theatre Department of
Anaesthesiology, Combined Military Hospital Quetta. Duration of study: Six month from 16th Sep 2011 to 15th March 2012. Material
and Method: Seventy women undergoing LSCS for singleton pregnancy under spinal anesthesia were randomly assigned in group A and
B (35 in each group). All patients preloaded with Lactated Ringer’s solution 15ml/kg body weight 10 minutes before administration of
spinal anaesthesia. Mean Arterial Pressure (MAP) was recorded before administration of spinal anaesthesia considered as Base-line
MAP 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 for
procedure after 10 minutes of spinal block. The SPSS version 13 was applied to the data. Mean and standard deviation were computed for
numerical variables like age, weight, height, systolic blood pressure, Diastolic blood pressure, and Mean Arterial pressure; whereas
frequency and percentages were employed to assess the categorical variable like efficacy. Chi-square test was used to compare the
efficacy of intravenous bolus of ephedrine and phenylephrine. Statistical significance was taken at p<0.05. Results: There was
significant difference in the efficacy of both the drugs, in the treatment of maternal hypotension. 74.29% were successfully treated in
group “A” with a single dose of Ephedrine, as compared to group B where 51.43% were successfully treated with a single dose of
Phenylephrine. (p-value = 0.048). Conclusions: Intravenous ephedrine has more efficacy than phenylephrine in the treatment of
maternal hypotension after spinal anesthesia for elective cesarean section.