Comparison of IV bolus phenylephrine, ephedrine and mephentermine for maintenance of hemodynamic status and its effect on fetal outcome during spinal anesthesia in cesarean section

Background: Maternal hypotension during spinal anesthesia for cesarean section is a persistent problem which can result in adverse maternal and fetal outcome. Aim: Aim of this study was to compare the efficacy of IV bolus phenylephrine, ephedrine and mephentermine for the maintenance of hemodynamic status and its effect on fetal outcome during spinal anesthesia in cesarean section. Materials and Methods: We did prospective randomized double blind study in 60 patients. They were undergoing elective cesarean section under spinal anesthesia and who developed hypotension after subarachnoid block. The patients were randomly divided into three groups of 20 each. Phenylephrine Group (Group P) received Inj. Phenylephrine 100 mcg IV, Group E received Inj. Ephedrine 6 mg IV and Group M received Inj. Mephentermine 6 mg IV bolus. Whenever hypotension occurred, patients received the study drug. After administration of drugs and their consistence Sneha Dokania, Renu Gurung, Ambuj Jain. Comparison of IV bolus phenylephrine, ephedrine and mephentermine for maintenance of hemodynamic status and its effect on fetal outcome during spinal anesthesia in cesarean section. IAIM, 2019; 6(9): 28-36. Page 29 maintenance till end of 60 minutes. Patients were compared with respect to age, weight, duration of surgery, Systolic BP, Diastolic BP, Mean Arterial Pressure and Heart Rate. Results: The rise of systolic, diastolic and mean arterial pressure in Group P was significantly high for first 4min of bolus dose as compared to Group E & Group M (P<0.05). APGAR scores were ≥7 in all the three groups. Conclusion: It was concluded that IV bolus Mephentermine is as effective as Phenylephrine and Ephedrine in maintenance of arterial blood pressure during spinal anesthesia in cesarean section with good neonatal outcome.