Comparison of Norepinephrine and Phenylephrine Boluses for the Treatment of Hypotension during Spinal Anaesthesia for Caesarean Section
Authors/Creators
- 1. Assistant Professor, Department of Anesthesiology, VIMSAR, Burla
- 2. Professor, Department of Anesthesiology, VIMSAR, Burla
- 3. Senior Resident, BB Medical College, Bolangir
Description
Background and Aims: Hypotension is common despite adequate fluid loading following spinal anaesthesia for caesarean section. Phenylephrine is presently the drug of choice to treat spinal hypotension following caesarean section. Recently, norepinephrine is being proposed as a substitute to phenylephrine boluses. The aim of the study was to compare the effectiveness of bolus doses of norepinephrine with phenylephrine to treat hypotension following spinal anesthesia for caesarean section. Methods: 100 patients undergoing elective caesarean section under spinal anaesthesia were randomly assigned into two groups. Group PE patients received phenylephrine 50 µg as an IV bolus and group NE received 4 µg of norepinephrine as IV bolus to treat hypotension following spinal anesthesia. The primary objective of the study was to compare the number of bolus doses of norepinephrine or phenylephrine needed to treat hypotension following spinal anesthesia. The secondary objectives were to compare the incidence of bradycardia, nausea and vomiting in mother and foetal outcomes. Results: The number of boluses of vasopressors required to treat hypotension was significantly lower in group NE (Group NE=1.36±0.563, Group PE=2.00±0.699, p-value=0.000). The frequency of bradycardia was high in group PE, and this difference was also statistically significant (Group NE=2 (4%), Group PE=11 (22%) p-value=0.015). Maternal complications such as nausea and vomiting and shivering were comparable between the groups. The fetal parameters were also comparable between both the groups. Conclusion: Intermittent boluses of norepinephrine are effective in the management of hypotension following spinal anesthesia for caesarean section. The fetal outcomes were comparable in both the groups. Norepinephrine boluses can be considered as a better alternative to phenylephrine boluses.
Abstract (English)
Background and Aims: Hypotension is common despite adequate fluid loading following spinal anaesthesia for caesarean section. Phenylephrine is presently the drug of choice to treat spinal hypotension following caesarean section. Recently, norepinephrine is being proposed as a substitute to phenylephrine boluses. The aim of the study was to compare the effectiveness of bolus doses of norepinephrine with phenylephrine to treat hypotension following spinal anesthesia for caesarean section. Methods: 100 patients undergoing elective caesarean section under spinal anaesthesia were randomly assigned into two groups. Group PE patients received phenylephrine 50 µg as an IV bolus and group NE received 4 µg of norepinephrine as IV bolus to treat hypotension following spinal anesthesia. The primary objective of the study was to compare the number of bolus doses of norepinephrine or phenylephrine needed to treat hypotension following spinal anesthesia. The secondary objectives were to compare the incidence of bradycardia, nausea and vomiting in mother and foetal outcomes. Results: The number of boluses of vasopressors required to treat hypotension was significantly lower in group NE (Group NE=1.36±0.563, Group PE=2.00±0.699, p-value=0.000). The frequency of bradycardia was high in group PE, and this difference was also statistically significant (Group NE=2 (4%), Group PE=11 (22%) p-value=0.015). Maternal complications such as nausea and vomiting and shivering were comparable between the groups. The fetal parameters were also comparable between both the groups. Conclusion: Intermittent boluses of norepinephrine are effective in the management of hypotension following spinal anesthesia for caesarean section. The fetal outcomes were comparable in both the groups. Norepinephrine boluses can be considered as a better alternative to phenylephrine boluses.
Files
IJPCR,Vol15,Issue8,Article33.pdf
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Additional details
Dates
- Accepted
-
2023-08-05
Software
- Repository URL
- https://impactfactor.org/PDF/IJPCR/15/IJPCR,Vol15,Issue8,Article33.pdf
- Development Status
- Active
References
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