ABSTRACT
Background and objectives: Hypotension following spinal anesthesia [SA] for cesarean delivery can have important consequences for parturient and may affect neonatal outcome. The objective of this study was to compare intravenous bolus doses of phenylephrine and ephedrine to treat hypotension after SA for cesarean section and the effect of vasopressors on fetal outcome in terms of Apgar score. Methodology: Two hundred parturient fulfilling inclusion criteria were r and omly allocated into two groups of hundred each. Lumbar puncture was done in sitting position and 10 mg, 0.5% hyperbaric bupivacaine was given intra-thecally to every patient. All patients were placed supine with 15 degree left lateral tilt position. If hypotension occurred after SA [systolic blood pressure less than 90 mm Hg or decrease in systolic blood pressure more than 20% of base line whichever is lower] was treated with either 100µg phenylephrine in Group A or6 mg ephedrine in Group B boluses given intravenously. Results: Single intravenous bolus dose of phenylephrine 100 µg was effective in treating hypotension in 92% parturient while ephedrine 6mg remained effective in 78% parturient, which was statistically significant [p= 0.0009]. There was no difference in the mean Apgar scores [p = 0.76] at 1 minute and [p = 0.09] at 5 min between the two groups. Incidence of bradycardia [heart rate < 50 beats/mints.] was significantly higher in Group A as compared to Group B [p=0.038]. Conclusion: Intravenous bolus dose of phenylephrine 100 µg and ephedrine 6mg were both effective in treating hypotension after SA for elective cesarean section. Mean Apgar scores of the neonates at 1 and 5 min were comparable between the two groups. Key words: Spinal anesthesia, cesarean section, hypotension, ephedrine and phenylephrine Citation: Siddiqui AS, Salim B, Siddiqui SZ. Comparison of phenylephrine and ephedrine for treating hypotension after spinal anesthesia for cesarean section: A R and omized double-blind clinical trial. Anaesth Pain and Intensive Care 2015;19[1]:44-49
ABSTRACT
Objective: To find out the frequency and severity of post-dural puncture headache [PDPH] after spinal anaesthesia for caesarean section using 25G Quincke spinal needle
Study design: Descriptive case series
Place and duration of study: Department of Anaesthesiology, Surgical Intensive Care and Pain Management, Civil Hospital Karachi, Dow University of Health Sciences Karachi, from July 2010 to June 2011
Methodology: Pregnant women, aged 18 to 40 year, ASA I and II, presenting for elective or emergency caesarean deliveries under spinal anaesthesia were included. Spinal anaesthesia was performed with standardized technique using 25G Quincke spinal needle. Patients were followed for three consecutive days postoperatively for the frequency and severity of postdural puncture headache
Results: Out of four hundred and fifty parturient, 337 underwent emergency operations while 113 operated electively. In more than 93% cases spinal anaesthesia was instituted in first attempt. Thirty nine out of 450 patients [8.7%] developed post-dural puncture headache after spinal anaesthesia for caesarean section with 25G Quincke spinal needle. Thirty one had mild headache while eight parturient developed moderate headache
Conclusion: The frequency of post-dural puncture headache was in conformity to what has been reported in literature using 25G Quincke spinal needle