Comparison of hemodynamic changes between phenylephrine and combined phenylephrine and glycopyrrolate groups after spinal anesthesia for cesarean delivery

Yoon, Haesang; Cho, Hong-Jei; Jee, Young Seok; Kim, Soo Mi

doi:10.4097/kjae.2012.62.1.35

Cited by 17 publications

(16 citation statements)

References 15 publications

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“…4 0 % ) d u r i n g intraoperative period. In our study, the incidence of intraoperative nausea and vomiting had been found to be high after cord clamping which was similar to that done by Albouleish EI et al 13 9,10,11,17,18 The neonatal outcome as determined by Apgar scores was statistically significant in glycopyrrolate group than in normal saline group but clinically insignificant because both the groups had satisfactory Apgar scores. However, in the study done by Ure D et al, 5 and Biswas et al, 12 there were no differences in neonatal Apgar scores between the two groups.…”

Section: Mjsbh Vol 15 Issue 1 Jan-jun 2016supporting

confidence: 90%

Effect of Glycopyrolate on Nausea, Vomiting and Neonatal Outcome During Spinal Anaesthesia for Elective Caesarean Section

Amatya

Acharya²,

Pradhan³

et al. 2016

Med. J. Shree Birendra Hosp.

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Introduction: Glycopyrrolate has better antisialagogue effect and does not cross placental barrier; thereby when given immediately before subarachnoid block for elective caesarean section might reduce incidence and severity of nausea and vomiting without affecting neonatal outcome. Methods: In a prospective randomized double blind placebo controlled study, sixty ASA PS I and II patients undergoing elective caesarean section at term were assigned to receive 1 ml of Inj Normal Saline IV or 1 ml (0.2 mg) of Inj Glycopyrrolate. After subarachnoid block, nausea score was assessed every 5 min during intraoperative period (before and after cord clamping), every 30 min for initial 4 hour and every 6 hour till 24 hr after surgery. Vomiting was assessed as mild (<2 episodes) and severe (>2 episodes). Apgar scores were recorded 1 min and 5 min after birth. Results:The severity of nausea was less in glycopyrrolate group than in normal saline group during intraoperative period (p value ≤ 0.001) and postoperative period (p value 0.31). During intraoperative and postoperative period, the severity of vomiting was mild in normal saline group where as in glycopyrrolate group there was no vomiting. The incidence of nausea was low in the parturient who received IV glycopyrrolate than those who received normal saline 3.33% vs. 60% (p value <0.001) during intraoperative period particularly after cord clamping 0 vs. 53.33% (p value <0.001). There was also reduced incidence of vomiting 0 vs. 13.33% (p value 0.03) during intraoperative period after cord clamping. All neonates born to the mother participating in the study had satisfactory Apgar score. Conclusions: Injection Glycopyrrolate when given as an IV premedication during spinal anaesthesia for elective caesarean section could reduce both the severity and incidence of nausea and vomiting during intraoperative period particularly after cord clamping without affecting neonatal outcome and causing side effects.

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Section: Mjsbh Vol 15 Issue 1 Jan-jun 2016supporting

confidence: 90%

Effect of Glycopyrolate on Nausea, Vomiting and Neonatal Outcome During Spinal Anaesthesia for Elective Caesarean Section

Amatya

Acharya²,

Pradhan³

et al. 2016

Med. J. Shree Birendra Hosp.

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“…The rise in HR in Group E was more as compared to Group P. The results of this study were in accordance with the study of other investigators. They also reported higher incidence of bradycardia in patients receiving phenylephrine as compared with patients receiving ephedrine for prevention of hypotension during spinal anesthesia for caesarean section (21)(22)(23). On contrary to the results of the present study, Adigun et al found bolus IV phenylephrine 100µg to be as effective as ephedrine 5mg with no significant difference in HR between two groups and an equivalent hypotensive control.…”

Section: Discussioncontrasting

confidence: 95%

Comparison of commonly used vasopressors for treating hypotension after spinal anaesthesia in elective lower abdominal surgery: a randomized, observational, case-control study

Kumari

Tahir²,

Kumari

et al. 2019

Int J Res Med Sci

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Background: During caesarean section hypotension due to spinal block is secondary to the sympathetic blockade and aorto-caval compression by the uterus. It can have important consequences for the mother and may affect neonatal outcome. The present study was aimed to compare intravenous bolus doses of phenylephrine and ephedrine to treat maternal hypotension during spinal block for elective caesarean section.Methods: After fulfilling the inclusion criteria, 100 parturient were randomly allocated into two groups of fifty each. For spinal anesthesia lumber puncture was done and 12.5mg, 0.5% hyperbaric bupivacaine was given intra-thecally. In this observational study, patients who developed hypotension under spinal anesthesia were selected for the study. According to their group, patients received either ephedrine 6mg (Group E) or phenylephrine 75µg (Group P) as vasopressor. During the study, number of vasopressor boluses, hemodynamic response and time taken to recover from hypotension was noted.Results: Ephedrine and phenylephrine were used in the mean doses of 6.72±1.97mg and 91.5±31.38µg respectively. In 88% parturient single bolus dose of ephedrine was effective in treating hypotension while phenylephrine was effective in 78% parturient. There was no significant difference observed in total number of boluses used. No significant difference was seen in mean systolic blood pressure, mean diastolic blood pressure and mean arterial pressure over a given period of time in Group E and Group P. Mean systolic BP was less than 20% when compared to baseline in both the groups at different time intervals. In Group P the mean heart rate was significantly lower as compared to the Group E (p<0.05).Conclusions: Intravenous phenylephrine and ephedrine are both similar in performance in treating hypotension after spinal anesthesia for elective caesarean section and the hypotensive control offered is comparable.

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“…The results of this study were in accordance with the study of other investigators in which they reported higher incidence of bradycardia in patients receiving phenylephrine as compared with patients receiving ephedrine for prevention of hypotension during spinal anesthesia for cesarean section. [ 10 11 12 ]…”

Section: Discussionmentioning

confidence: 99%

“…Nowadays spinal anesthesia is widely used for elective lower abdominal surgeries. [ 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 ] It is frequently accompanied by hypotension, which may be defined in absolute terms as a systolic blood pressure (SBP) less than 90 or 100 mmHg or in relative terms as a percentage (20% fall from baseline). [ 1 ] The severity of this hypotension depends on the height of the block, the position of the patient, and the volume status of them.…”

Section: Introductionmentioning

confidence: 99%

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A Comparison of Intravenous Ephedrine or Phenylephrine, for Prevention of Postspinal Hypotension during Elective Lower Abdominal Surgery: A Randomized, Double-blind Case–control Study

2017

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Background:In this randomized, double-blinded case–control study, we investigated the intravenous effects of ephedrine or phenylephrine on prevention of post–spinal hypotension in elective lower abdominal surgery under spinal anesthesia.Materials and Methods:One hundred and thirty-five patients, American Society of Anesthesiologists physical status I or II candidate for elective lower abdominal surgery under spinal anesthesia were randomized to three groups (45 each). According to their allocated group, patients received either ephedrine 2.5 mg (E group), phenylephrine (P group) 25 mic as vasopressor or the same volume of saline normal as placebo (S group) immediately after the spinal anesthesia. hemodynamic parameters, and complications were recorded.Results:Patients’ demographics were similar in all the groups. The mean systolic blood pressure (SBP), diastolic blood pressure (DBP), and MAP and also heart rate were similar over time for groups E and P (P > 0.05). The incidence of reactive hypertension was more in group E than group P and placebo (P < 0.05). The incidence of nausea and vomiting were significantly lower in groups E and P in comparison with placebo (P < 0.05).Conclusion:Although the mean fall of SBP and DBP were significantly less in groups E and P compared with placebo but we did not find significant differences in prophylactic use of ephedrine or phenylephrine for prevention of post–spinal hypotension in elective lower abdominal surgery. Vasopressors infusion have added benefit of lower incidence of nausea and vomiting.

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Comparison of hemodynamic changes between phenylephrine and combined phenylephrine and glycopyrrolate groups after spinal anesthesia for cesarean delivery

Cited by 17 publications

References 15 publications

Effect of Glycopyrolate on Nausea, Vomiting and Neonatal Outcome During Spinal Anaesthesia for Elective Caesarean Section

Effect of Glycopyrolate on Nausea, Vomiting and Neonatal Outcome During Spinal Anaesthesia for Elective Caesarean Section

Comparison of commonly used vasopressors for treating hypotension after spinal anaesthesia in elective lower abdominal surgery: a randomized, observational, case-control study

A Comparison of Intravenous Ephedrine or Phenylephrine, for Prevention of Postspinal Hypotension during Elective Lower Abdominal Surgery: A Randomized, Double-blind Case–control Study

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