A randomized controlled trial of prophylactic phenylephrine infusion to reduce spinal anaesthesia hypotension during elective caesarean delivery

Dr. Aldiona S Bhattacharyya; Dr. Jyoti Kumari

Volume : X, Issue : II, February - 2020

A randomized controlled trial of prophylactic phenylephrine infusion to reduce spinal anaesthesia hypotension during elective caesarean delivery

Dr. Aldiona S Bhattacharyya, Dr. Jyoti Kumari

Abstract :

Hypotension associated with spinal anaesthesia for caesarean delivery can have deleterious effects on mother as well as the fetus. The objective of our study was to investigate the prophylactic phenylephrine infusion for prevention of hypotension during spinal anaesthesia for caesarean delivery. 120 parturients consenting for the study, posted for elective caesarean delivery, were included in the study and randomly allocated into two groups. Immediately after intrathecal injection, phenylephrine was started at 100µg/min(n=60) until uterine incision. Systolic arterial pressure (SAP), mean arterial pressure (MAP), heart rate, ECG and SpO2 were recorded at every 3 minutes interval until uterine incision. A control group (n=60) received normal saline infusion at 1ml/min, starting immediately after intrathecal injection until uterine incision. Parturients received intravenous bolus phenylephrine when the SAP was < 80% of baseline or < 100 mmHg. Bradycardia was defined as heart rate < 50 beats/min. Phenylephrine decreased the incidence (0[0%] of 60 versus 31[52%] of 60) and number of episodes (0 versus 31; p<0.001) of hypotension compared with control(p<0.0001). Heart rate progressively decreased over time in the infusion group compared with the control. Conclusion: Prophylactic phenylephrine infusion is a simple and effective method of maintaining blood pressure during spinal anaesthesia for caesarean delivery.