RESUMO
Aim of the study is to compare the efficacy of Ephedrine and Phenylephrine for treatment of hypotension after spinal anaesthesia for elective caesarean section. Randomized Clinical Trial. Operation theatre Department of Anaesthesiology, Combined Military Hospital Quetta. Six month from 16th Sep 2011 to 15th March 2012. 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 and 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. 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]. Intravenous ephedrine has more efficacy than phenylephrine in the treatment of maternal hypotension after spinal anesthesia for elective cesarean section
RESUMO
There is increase incidence of Lower Segment Caesarean section [LSCS] being performed under sub-arachnoid block [SAB] because it is relatively safe. One of the complications of SAB is Post Dural Puncture Headache [PDPH] which is very distressing to the patient. To observe the incidence of PDPH by using two different types of spinal needle of 25 gauge in females undergoing LSCS under SAB. Currently, in our setup 25G cutting [quincke] spinal needle is routinely used. Randomized controlled trial. Department of Anesthesia, Officers Family Hospital, Rawalpindi Cantt. 6 months from 15 February 2011 to 15 July 2011. 100 pregnant patients undergoing elective CD under spinal anaesthesia were randomized into two group A and B. Group A received SAB with 25G Quincke needle; Group B-received SAB with 25G pencil-point needle. Follow up was done up to 72 hours after the surgery. Data obtained through study was analysed through computer software SPSS version 12. quantitative variables like age, weight and height are presented as mean and standard deviation. The frequency of PDPH was qualitatively analysed in percentage. The frequency of PDPH was compared between two groups with the application of Chi-square as test of significance at P-value <0.05. It was found that the incidence of PDPH with Quincke [cutting tip] needle was significantly higher [7.%] as compared to pencil point needle [0%]. Pencil-point needle is associated with lesser incidence of PDPH and should be preferred to Quincke needle to achieve SAB in patients undergoing LSCS