Prophylactic Ephedrine Versus Phenylephrine for Prevention of Hypotension in Severe PreEclamptic Parturients Uundergoing Cesarean Section Under Spinal Anesthesia and Effects on the Maternal Hemodynamics,
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- Category: Vol. 84, March 2016
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Prophylactic Ephedrine Versus Phenylephrine for Prevention of Hypotension in Severe PreEclamptic Parturients Uundergoing Cesarean Section Under Spinal Anesthesia and Effects on the Maternal Hemodynamics, MOHAMED Y. MOHAMED, JEHAN H. IBRAHIM and TAMER F. SAFAN
Abstract
Objective: Is to compare the efficacy of phenylephrine and ephedrine in the prevention of spinal anesthesia induced hypotension in severe preeclamptic patients undergoing ce-sarean delivery, evaluate the side effects of this therapy.
Methods: 60 severely pre-eclamptic patients randomly allocated into 2 equal groups (30 patients each) using computer generated numbers and concealed using sequentially numbered, sealed opaque envelope technique.
Group E (ephedrine): Patients received bolus of 10 mil-ligram of ephedrine i.v immediately after the subarachnoid block.
Group P (phenylephrine): Patients received bolus of 100 microgram of phenylephrine i.v immediately after the sub-arachnoid block.
Results: The mean heart rate was higher in the ephedrine group than in the phenylephrine group which is statistically significant (p=0.04). Patients in the phenylephrine group were more likely than the Ephedrine group to develop bradycardia. There is difference over time in heart rate between ephedrine and phenylephrine groups was statistically significantly between 12 to 18 minutes after spinal anesthesia (p<0.05). Overall, the systolic, diastolic ,and mean arterial blood pressure readings from spinal anesthesia until 24 hours postoperative were were similar for both groups.
Conclusion: This study demonstrated that 100-μg i.v bolus dose of phenylephrine is as effective as 10-mg i.v bolus dose of ephedrine as a prophylactic measure for preventing hypotension after spinal anaesthesia for cesarean section in severe pre-eclamptic patients after prehydration with 250ml lactated Ringer's solution.