Prophylactic administration of two different bolus doses of phenylephrine for Prevention of spinal -induced hypotension during cesarean section: A Prospective double-blinded Clinical Study

Abstract

Aim: The aim of the present study was Prophylactic administration of two different bolus doses of phenylephrine for Prevention of spinal - induced hypotension during cesarean section: A Prospective double-blinded Clinical Study

Methods: This prospective double‑blinded study was conducted at Department of Anaesthesiology and CCM, IGIMS, Patna, Bihar, India  for the period of one year. We enrolled 150 parturients of American Society of Anesthesiologists (ASA) grade I or II between 18 to 35 years of age and posted for elective cesarean delivery under spinal anesthesia.

Results: Demographic and obstetric data such as age, weight of mother, gestation week, parity, and duration of surgery and anesthesia were comparable in all the three groups. The total fluid requirement of the control group was significantly more (P < 0.001) as compared to the other two groups. Incidence of hypotension was significantly (P < 0.001) more in the control group (72%) than groups P75 (24%) and P100 (18%). The need for administering rescue vasopressors was  significantly  delayed  in  groups P75 and P100 ascompared to the control group. The total dose volume (mg) and the number of doses of phenylephrine were significantly higher in the control group than in the groups P75 and P100 (P < 0.001).The P100 group showed a significant fall in HR from baseline after 4 min of SAB and remained significantly low throughout the intraoperative period (p < 0.001). The mean value of lowest HR (bpm) was highly significant in P100 as compared to P75 and P0. Higher incidence of bradycardia was observed in group P100 (38%) than P75 (16%) and control group (10%).

Conclusion: Prophylactic administration of bolus phenylephrine significantly decreases the incidence of maternal hypotension and a dose of 75 µg is adequate to prevent post‑spinal hypotension for cesarean delivery without any detrimental effect on the neonatal and maternal outcomes.