Volume : IX, Issue : II, February - 2020

COMPARISION OF INTRAVENOUS PHENYLEPHRINE WITH INTRAVENOUS MEPHENTERMINE FOR MANAGEMENT OF POST SPINAL HYPOTENSION IN CASES OF CAESAREAN SECTION

Dr. Rajan Kumar, Dr. Chhaya M Suryawanshi, Dr. Debarshi Jana

Abstract :

INTRODUCTION: Hypotension following spinal anaesthesia forCaesarean section is one of the common problem encounteredby an anaesthesiologist. This study was aimed at compåthe efficacy of IV bolus Phenylephrine andMephentermine for management of fall in arterial blood pressure more than 20 % of baseline following spinal anesthesia in caesarean section. AIMS AND OBJECTIVE: This study was done to compare the effectiveness of bolus doses of intravenousmephentermine 6 mg and intravenous phenylephrine 100 mcg , for the management of post spinal hypotension in cases of caesarean section and their effects on neonate. MATERIALS AND METHODS This study was done on 60 patients undergoing elective as well as emergency caesarean sections under spinal anaesthesia ,after taking Institutional Ethics Committee approval ,and informed written consent . The protocol was explained to all patients in detail in their own language. All patients under ASA grade I or II Ages between 20 to 35 and weighing between 55 to 70 kg , having uncomplicated singleton pregnancy having Baseline systolic blood pressure between 100–140 mmHg and diastolic blood pressure between 70–89 mmHg ,developing hypotension after subarachnoid block (SAB) were included. Hypotension is defined as fall in systolic pressure >20% from the baseline value or a value less than 90 mmHg. All the patients were divided into two groups, namely, Group P & Group M.. Patients were randomly allocated to one of the two groups by Double Blind method, according to the drug to be used : Group P: Phenylephrine 100 microgram (0.1 mg) in 1 ml as IV bolus. Group M: Mephentermine 6 mg in 1 ml as IV bolus. Adequate preloading was done, pulse rate, systolic and diastolic arterial pressure were recorded thrice when middle value Was taken as a base line values. Hyperbaric bupivacaine 0.5% (1.8 to 2 ml) in volume was used for establishing spinal Anaethesia under all aseptic precaution. After subarachnoid block ,following parameters . pulse rate , blood pressure monitoring(S.B.P, D.B.P, Mean B.P), ECG monitoring,OxygenSaturation,Respiratory Rate –were recorded at every 1 min for 20 min and thereafter every 5 min till the end of surgery Whenever hypotension occurs the study drug Was given IV. The adycardia i.e. a pulse rate of 50/min or less Was treated with Atropine 0.3 mg iv. OBSERVATION AND RESULT In the study group fall in blood pressure was 20 to 25 % of baseline. Correction of fall in blood pressure was within 1 minute in the Phenylephrine group and 2 to 3 minute in Mephenterminegroup.Fall in pulse rate was 15 to 17 % of baseline in Phenylephrine group but not seen in Mephenterminegroup.Six cases had to be given Atropine 0.3 mg to manage adycardia.There was no significant effect of vasopressors on fetus in terms of APGAR Score.

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Article: Download PDF    DOI : 10.36106/ijsr  

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COMPARISION OF INTRAVENOUS PHENYLEPHRINE WITH INTRAVENOUS MEPHENTERMINE FOR MANAGEMENT OF POST SPINAL HYPOTENSION IN CASES OF CAESAREAN SECTION, Dr.Rajan Kumar, Dr.Chhaya M Suryawanshi, Dr. Debarshi Jana INTERNATIONAL JOURNAL OF SCIENTIFIC RESEARCH : Volume-9 | Issue-2 | February-2020

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