Phenylephrine for the management of hypotension during spinal anesthesia for cesarean section delivery

Abstract

Objectives: To evaluate the efficacy of intravenous phenylephrine for the control of spinal anesthesia induced intra- operative hypotension in C- section and its side effects. Methods: A cross-sectional descriptive study was conducted on 322 women with indications of spinal anesthesia for C- section received IV phenylephrine (50-100 µg) titrated to maintain maternal systolic BP at near-baseline values. Results: The mean SBP was ≤ 95% of the baseline from 2 to 10 minutes after the spinal anesthesia induction, then gradually stabilized until the end of surgery. In which, mean SBP <80% and <70% of the baseline at 3rd and 4th minute were 34.16% and 36.33%; 10.86% and 11.80%, respectively. Heart rate decreased > 10 beats per minute (bpm) by the 6th minute till the end of surgery, 4.04% of patients had bradycardia (<55 bpm). The average IV dose of phenylephrine was 95,96 ± 36,16µg. Total crystalloid solutions loading volume at the moment of and just after spinal anesthesia (“co-/postloading”) was 1222.89 ± 141.67ml. 7,76% of patients had vomiting. The average one - minute and five - minutes APGAR score were 8.35 ± 0.24 and 8.99 ± 0.07, respectively. Conclusion: Phenylephrine for managing hypotension during spinal anesthesia for cesarean section was a safe and effective strategy of choice.