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Shah, Pratibha (Jain)
- Intravenous Bolus Phenylephrine, Ephedrine and Mephentermine for Maintenance of Blood Pressure During Spinal Anaesthesia in Caesarean Section: A Comparative Study
Authors
1 Professor, Department of Anaesthesia, Pt. JNM Medical College, Raipur (C.G.), IN
2 Balaji Multispecialty Hospital, Raipur (C.G.), IN
3 Associate Professor, Department of Anaesthesia, Pt. JNM Medical College, Raipur (C.G.), IN
4 Professor and Head, Department of Anaesthesia, Pt. JNM Medical College, Raipur (C.G.), IN
Source
Central Journal of ISA, Vol 2, No 1 (2018), Pagination: 8-13Abstract
Objective: To study the efficacy of intravenous bolus Phenylephrine, Ephedrine and Mephentermine for maintenance of Blood Pressure during Spinal Anesthesia in patients undergoing emergency Caesarean Section.
Materials and Methods: One hundred twenty, ASA type 1 and 2 patients scheduled for emergency caesarean section under spinal anaesthesia who developed hypotension were allocated into 3 groups of 40 each. Group P received Phenylephrine 0.1mg, Group E received Ephedrine 6 mg, and Group M received Mephentermine 6 mg in 1 ml as bolus IV.
Results: The rise of diastolic blood pressure at 2, 4, and 6 minutes post study drugs were significantly less in Ephedrine and Mephentermine group as compared to the Phenylephrine group (p<0.05). Similarly elevation of systolic blood pressure in Phenylephrine group was significantly higher as compared to other two groups for first 6 minutes. Thereafter the differences narrowed off. No significant differences were observed between changes in systolic and diastolic blood pressure of Ephedrine and Mephentermine group at any point of time. In Phenylephrine group, post study drug values of heart rate decreased significantly from the values at onset of the hypotension till the end of the surgery when compared to other two groups (p<0.001). Neonatal Apgar score at 1 and 5 min were >7 in all three groups.
Conclusion: Phenylephrine group had quicker control of blood pressure compared to the other two groups. However, as the time elapsed all drugs achieved comparable control of blood pressure. Phenylephrine did show some advantage over others with regard to reduction in heart rate.
Keywords
Bolus, Ephedrine, Mephentermine, Phenylephrine.Full Text
References
- Pernoll ML, Mandell JE. Caesarean section. Chapter 30, Principles and Practice of Obstetric Analgesia and Anaesthesia, 2nd Edn., Bonica JJ and McDonald JS, Williams and Wilkins. 1995:968-1009.
- Clyburn P. Spinal anaesthesia for caesarean section: time for reappraisal? (Editorial) Anaesthesia 2005; 60:633-3. https://doi.org/10.1111/j.1365-2044.2005.04282.x PMid:15960712
- Parameshwara G. Spinal, epidural to combined spinal epidural analgesia. The history of central neuraxial block. Indian J Anaesth. 2001; 45(6):406.
- Eloner H, Barcohana J, Bartosheck AK. Influence of post spinal hypotension on fetal electrogram. Am J Obstet Gynecol. 1960; 80:560-72.
- Sahu D, Kothari D, Mehrotra A. Comparison of bolus phenylephrine, ephedrine, and mephentermine for maintenance of arterial pressure spinal anaesthesia in caesarean section – a clinical study. Indian J Anaesth. 2003; 47(2):125-8.
- Reidy J, Douglas J. Vasopressors in obstetrics. Anesthesiol Clin. 2008; 26:75-88. https://doi.org/10.1016/j.anclin.2007.11.005 PMid:18319181
- Thomas DG, Robson SC, Redfern N, Hughes D, Boys RJ. Randomized trial of bolus phenylephrine or ephedrine for maintenance of arterial pressure during spinal anaesthesia for caesarean section. Br J Anaesth. 1996; 76:61-5. https://doi.org/10.1093/bja/76.1.61
- Ganeshavar AK, Shetty S, Shettar AE, Koppal R, Ravi R. Comparison of bolus phenylephrine, ephedrine and mephentermine for maintenance of arterial pressure during spinal anaesthesia in caesarean section. J. clin. diagn. res. 2011 October; Vol-5(5): 948-952.