ABSTRACT
The objective of this study was to compare the hemodynamic effects of use of prophylactic intravenous ephedrine with ephedrine use on as needed basis in patients receiving spinal anesthesia for caesarean sections. A double blind, randomized, comparative trial. Department of Anaesthesiology, Critical Care, and Pain Management, Shifa International Hospital Islamabad. October 2007 to March 2008. Seventy patients were recruited who were scheduled to receive spinal anaesthesia for C-section. The patients were randomized into two groups [A and B]. In patients of Group A [control group] ephedrine was used to treat hypotension when indicated, while in Group B [intervention group], patients received prophylactic ephedrine soon after the subarachnoid block. Hemodynamic changes were recorded and the data was analysed. In Group A, the blood pressure dropped in a higher number of patients [23 [65.7%]], as compared to Group B [6[17.1%]]. This difference was statistically significant [p<0.001]. Prophylactic ephedrine is better than ephedrine prn in prevention of hypotension in patients receiving spinal analgesia for C-Section
ABSTRACT
We present here successful management of a patient of severe HELLP syndrome, secondary to retained products of conception [POC's]. The management of our patient started just after her presentation in the emergency department of our hospital. Clinical history of post-partum bleeding, fits and confusion, along with deranged laboratory investigations lead us to an aggressive management plan, conducted by a team of healthcare professionals and the patient was saved