Efficacy of Prophylactic Phenylephrine in Prevention of Hypotension in Parturient Undergoing Spinal Caesarean Section

Abstract

OBJECTIVE: To determine the hemodynamic (pulse, blood pressure) stability of prophylactic bolus dose of phenylephrine in caesarean section under spinal anaesthesia. Study design & Setting: Interventional study was done from 13th Feb 2021 to 07th Oct 2021 at Islam Teaching Hospital, Sialkot. Methodology: Study approval was taken vide letter no.2021-05/AN dated 26-3-2021, issued by Chairman Ethical Review Board, Islam Medical College, Sialkot. Statistical software(version.3.1.9.2) with (prob of 0.80, critical 2 value 15.08), was employed and sample size calculated to be 200 cases i.e. groups-I (injection phenylephrine 100µgm) and group-II (placebo) divided by lottery method into 100 each given at spinal neuraxial block. Primary study variable being heart rate and blood pressure variations. Spearman’s Rank correlation statistical test was used to check interdependence between the two variables i.e., systolic blood pressure and pulse rate. SPSS version 21 was used. Results: In group-II, in 36% cases atropine was given as compared to 24% cases in group-I, thus 150 % more anti-cholinergic was used in group-II. In group-II, in 33% cases top-up of injection Adrenaline 10 microgram was used whereas given in 24% cases in group-I, thus 137.5 % more top-ups of vasopressors in group-II. In group-I, heart rate decreased by value of 9.02 % with respect to baseline value, while comparable reading noted was 3.42% decline in pulse rate in group-II respectively. Conclusion: Prophylactic phenylephrine at time of spinal injection resulted in stable blood pressure and pulse rate values in caesarean spinal delivery.