Use of phenylephrine as vasopressor of choice to prevent hypotension following spinal anaesthesia in LSCS

Pinto, Vasanthi; Jaysundara, NS; Abeysundara, AB; Ekanayake, SU

doi:10.4038/slja.v16i2.349

Cited by 3 publications

(1 citation statement)

References 19 publications

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“…In consistent with our results, the study of Thiangtham and Asampinwat indicated to the similar impact of ephedrine and phenylephrine on the incidence of headache [25]. In contrast with our results, some studies indicated to the higher incidence of headache in ephedrine groups compare with phenylephrine which it might be due to the method or dosage of ephedrine [26,27].…”

Section: Comparison Of Ephedrine and Phenylephrine In Incidence Of Hecontrasting

confidence: 56%

Comparison of ephedrine and phenylephrine in incidence of headache during spinal anesthesia in cesarean delivery

Yari¹,

Choubsaz²,

Farzam³

et al. 2018

biomedicalresearch

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Background: Spinal anesthesia is more acceptable method of anesthesia in elective cesarean section, but hypotension is the major limitation of this technique which might trigger to serious complications for both mother and fetus. The use of vasopressors is necessary to control hypotension caused by spinal anesthesia, however, it might be along with side effects like headache. Methods: In the present study, 105 candidates for elective cesarean delivery were assessed to compare the role of ephedrine and phenylephrine in relation with the incidence of headache. Pearson Chi-square test, Kruskal-Wallis test, Spearman's rho correlation coefficient was performed to analyse the data. P value<0.05 was considered significant. All data were analysed using Stata 12. Results: The incidence of headache during the surgery was 51.4%, 45.7% and 37.1% in ephedrine, phenylephrine and control groups respectively. Not a significant difference was found between ephedrine and phenylephrine regarding the incidence of headache (P=0.541), also no significant difference were found in the severity of the headache (P=0.277). The severity of the headache was not different 24 h after surgery. The number of doses of vasopressor consumption in ephedrine and phenylephrine recipients was not significantly different (P=0.579). No significant difference was found between the number of doses used and the severity of the headache during surgery (P=0.979). However, the average of systolic blood pressure in ephedrine group was higher than phenylephrine group (P=0.001). Also, the impact of ephedrine and phenylephrine on heart rate was similar and affectless. Conclusions: In this study, no significant differences were observed in the incidence and severity of headaches during and after surgery, and the number of doses of vasopressor drug consumption between phenylephrine and ephedrine recipients to treat hypotension associated with spinal anesthesia in cesarean section.

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Section: Comparison Of Ephedrine and Phenylephrine In Incidence Of Hecontrasting

confidence: 56%

Comparison of ephedrine and phenylephrine in incidence of headache during spinal anesthesia in cesarean delivery

Yari¹,

Choubsaz²,

Farzam³

et al. 2018

biomedicalresearch

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Comparison of Phenylephrine and Ephedrine in the Treatment of Hypotension and Its Effects on the Foetus after Subarachnoid Block for Caesarean Section

Muneer¹,

Khurshid²,

Venkatesh³

2021

jemds

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BACKGROUND Subarachnoid block has been widely used for caesarean sections and is found to be safe. Hypotension being the most common complication may adversely affect both the mother and foetus. Different measures used to treat this hypotension include preloading with crystalloids/colloids and treatment with vasopressors. The standard choice of vasopressor agents such as ephedrine and phenylephrine is still a controversial issue. It is therefore important to compare the efficacy of the two drugs in the prevention and treatment of maternal hypotension after subarachnoid block and particularly assess their effect on the foetus. The purpose of this study was to assess and compare the foetal acid-base status and APGAR score following administration of bolus dose of ephedrine or phenylephrine that was given intravenously for maintenance of arterial blood pressure during lower segment caesarean section (LSCS) under a subarachnoid block. METHODS 100 parturients (18 to 35 years) scheduled for elective caesarean section under subarachnoid block were selected and divided into two groups of 50 each. Group P received 50 mcg i.v bolus of phenylephrine and Group E received 6 mg of ephedrine IV bolus whenever the blood pressure dropped 20 % from baseline or systolic blood pressure ˂ 90 mmHg. Haemodynamic parameters were measured in all patients. APGAR scores at 1 and 5 minutes following delivery of baby were assessed and cord blood was obtained for acid-base status analysis immediately following delivery. RESULTS Hemodynamic parameters including heart rate, systolic blood pressure, diastolic blood pressure, and mean arterial pressure did not show any significant difference between the two groups, however, Group E showed higher heart rates. The difference in umbilical artery pH (P-value < 0.001) and base excess (P-value = 0.004) was statistically significant with Group E showing lower pH and higher base excess values than Group P. There was no statistically significant difference in neonatal APGAR scores between the two groups. CONCLUSIONS Phenylephrine and ephedrine are equally efficient in managing hypotension during subarachnoid block for caesarean delivery. Thus, either vasopressor can be used although phenylephrine may be a better choice. KEY WORDS Caesarean Section, Phenylephrine, Ephedrine.

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A Prophylactic Phenylephrine Infusion for Preventing Hypotension during Spinal Anaesthesia for Caesarean Section and to Study its Effects on APGAR Score and Umbilical Artery Blood pH

Mohammad¹

2016

jmscr

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Use of phenylephrine as vasopressor of choice to prevent hypotension following spinal anaesthesia in LSCS

Cited by 3 publications

References 19 publications

Comparison of ephedrine and phenylephrine in incidence of headache during spinal anesthesia in cesarean delivery

Comparison of ephedrine and phenylephrine in incidence of headache during spinal anesthesia in cesarean delivery

Comparison of Phenylephrine and Ephedrine in the Treatment of Hypotension and Its Effects on the Foetus after Subarachnoid Block for Caesarean Section

A Prophylactic Phenylephrine Infusion for Preventing Hypotension during Spinal Anaesthesia for Caesarean Section and to Study its Effects on APGAR Score and Umbilical Artery Blood pH

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