Hypotension after spinal anaesthesia; efficacy of ephedrine and phenylephrine for treatment during elective caesarean section

ABSTRACT

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