A randomised comparative study to compare the prophylactic use of phenylephrine and norepinephrine in caesarean delivery under spinal anaesthesia

C. Ali, J. Bajaj
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Abstract

Background: To compare the efficacy and safety of prophylactic intravenous infusions of phenylephrine (0.1 μg/kg/min) and norepinephrine (NE) (0.05 μg/kg/min) for the management of maternal hypotension under spinal anesthesia for cesarean delivery. Methods: A prospective randomized comparative interventional study was conducted on 100 pregnant patients who underwent elective/emergency cesarean section under the sub-arachnoid block. The study patients were randomly allocated into two equal groups comprising of Group P (n = 50): who received phenylephrine 0.1 μg/kg/min infusion prophylactically and Group N (n = 50): who received norepinephrine 0.05 μg/kg/min infusion prophylactically. The data of outcome measures were compared among the two groups by SPSS ver 21.0. Results: A significant difference was seen in the incidence of bradycardia between groups P and N (20% vs 4%, P value = 0.028). The blood pressure was significantly higher in Group N (systolic-120.5 vs 104 mm of Hg, P = 0.026; diastolic-66 vs 61 mm of Hg, P = 0.019). Group N patients had no complications whereas Group P patients experienced nausea (8%) and vomiting (4%), P = 0.027. Neonatal outcomes in terms of Appearance, Pulse, Grimace, Activity, and Respiration (APGAR) score and umbilical arterial/venous blood gases were similar among the two groups (P > 0.05). Conclusion: In conclusion, the study results show that NE is better in maintaining the hemodynamic parameters (BP and HR) during spinal anesthesia for cesarean delivery with minimal side effects. It can be suggested that NE may be advantageous in pregnancies especially those complicated with pregnancy-induced hypertension.
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一项比较脊髓麻醉下剖宫产预防使用苯肾上腺素和去甲肾上腺素的随机对照研究
背景:比较预防性静脉输注苯肾上腺素(0.1μg/kg/min)和去甲肾上腺素(0.05μg/kg/min.)治疗剖宫产腰麻下产妇低血压的有效性和安全性。方法:对100例在蛛网膜下腔阻滞下进行选择性/紧急剖宫产的孕妇进行前瞻性随机对照干预研究。研究患者被随机分为两组,分别为P组(n=50):预防性输注0.1μg/kg/min的苯肾上腺素。两组患者的结果测量数据采用SPSS版本21.0进行比较。结果:P组和N组的心动过缓发生率有显著差异(20%vs 4%,P值=0.028)。N组的血压显著升高(收缩度-120.5 vs 104 mm Hg,P=0.026;舒张度-66 vs 61 mm Hg,P=0.019),N组患者没有并发症,而P组患者出现恶心(8%)和呕吐(4%),P=0.027。两组新生儿在外观、脉搏、Grimace、活动和呼吸(APGAR)评分以及脐动脉/静脉血气方面的结果相似(P>0.05)。结论:总之,研究结果表明,NE在剖宫产腰麻期间更好地维持血液动力学参数(BP和HR),副作用最小。提示NE可能对妊娠有利,尤其是对合并妊娠高血压的妊娠有利。
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来源期刊
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发文量
37
审稿时长
29 weeks
期刊最新文献
To study maternal hypotension, side-effects and fetal acid-base balance during cesarean delivery under spinal anesthesia using prophylactic infusion doses of 25 and 50 μg/Min phenylephrine Takotsubo cardiomyopathy in pregnancy: A focused review Comparative evaluation of two doses of phenylephrine infusion to prevent intra-operative nausea and vomiting during elective obstetric spinal anesthesia Carbetocin: Are we ready for a paradigm shift? Evaluation of perfusion index as a screening tool for prediction of hypotension and shivering in cesarean section
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