Babita Lahkar, Kalpajit Dutta, Dipika Choudhury
BACKGROUND A vasopressor drug is often required to control hypotension. Many authors have compared ephedrine and phenylephrine as vasopressor in patients undergoing elective cesarean section with conflicting conclusions, but none have evaluated these two agents in patients from the North-Eastern part of India. As a secondary objective, we intended to evaluate the side effects and umbilical artery blood pH (UApH). MATERIALS AND METHODS Term parturients of ASA-I and ASA-II category, in the age group of 20-30 years, with weight of 50-70 kg and height of 150- 170 cms posted for elective caesarean section under spinal anaesthesia were selected for the study. After dural puncture with a 23G spinal needle, 2.5 ml of 0.5% bupivacaine heavy was injected. Systolic and diastolic blood pressures (SBP and DBP) were recorded after subarachnoid block, and then every 2 mins for next 20 mins and thereafter every 5 mins till 30 minutes. Whenever the SBP falls below 20% of the baseline value, the study drug was given. Rescue atropine sulphate (0.3 mg IV) was given when the heart rate became less than 50. RESULTS The number of boluses of phenylephrine(Group-P) required to maintain maternal blood pressure were less as compared to Ephedrine(Group- E) in the first 6 minutes. In Group-P, 23.33% patients required single dose of Atropine to treat bradycardia and 76.67% patients did not require any atropine dose. In Group- E, no patients required any rescue dose of Atropine. Higher UApH in Group-P (Mean 7.37±0.023) as compared to Group-E (7.319±0.021) was noticed. CONCLUSION The maternal blood pressure was better maintained with phenylephrine as compared to ephedrine. There was less maternal heart rate along with statistically significant higher UApH in the patients receiving phenylephrine.
