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Category: Volume 11 Issue 02 February 2023
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Title: Comparison of single dose phenylephrine, ephedrine and mephentermine for maintenance of arterial pressure during spinal anesthesia in caesarean section

Authors: Ruthwik S Nambisan, Sheeila Rani Imanual, Jamuna Rani, Madhusoodhanan Pillai

 DOI: https://dx.doi.org/10.18535/jmscr/v11i2.08

Abstract

Introduction: Anesthesia to a parturient is not only unique but also requires highest degree of care because the anesthesiologist has to look after two individuals, the mother and foetus. Hypotension during spinal anesthesia for caesarean delivery can have detrimental effects on both mother and neonate. In this study we compare the efficacy of Ephedrine, Mephentermine and Phenylephrine in treating the hypotension for caesarean section and their effects.

Materials and Methods: The primary objective of the study was to compare the single doses of intravenous Phenylephrine, Ephedrine, and Mephentermine for maintenance of arterial pressure during spinal anesthesia in caesarean section. A prospective Observational study was conducted on 90 patients undergoing caesarean section under spinal anesthesia who are allocated to one of the 3 groups (30 in each group) based on the vasopressor given (ie, ephedrine, mephentermine and phenylephrine). The sampling technique involved consecutive sampling and the data obtained were recorded in to a structured proforma. Statistical analysis was performed using statistical software package SPSS version, 20.0.

Results: All the three vasopressors effectively maintained arterial pressure within 20% limit of baseline value though phenylephrine maintained better in first 8 minutes of bolus dose as compared to ephedrine and mephentermine. In phenylephrine group, post study drug values of heart rate were decreased significantly from the values at onset of the hypotension till the end of the surgery when compared to other two groups.

Conclusion: Phenylephrine, ephedrine and mephentermine are effective in IV bolus form in maintenance of arterial pressure within 20% limit of baseline though phenylephrine has quicker peak effect of comparison to ephedrine & mephentermine and it causes reduction in heart rate, which may be advantageous in cardiac patients and patients in whom tachycardia is undesirable.

Keywords: Phenylephrine, Ephedrine, Mephentermine, Arterial pressure, Spinal anesthesia, Caesarean section.

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Corresponding Author

Ruthwik S Nambisan

Senior Resident, Department of Anesthesiology, Govt. Medical College, Thiruvananthapuram