Efficacy of Atropine to Blunt Unopposed Vagal Activity in Prevention of Hypotension in Parturients Undergoing Spinal Caesarean Section

Abstract

Objective: To determine efficacy of prophylactic atropine to blunt un-opposed vagal activity in prevention of hypotension associated with caesarean spinal block in first 15 minutes. Study Design & Setting: Randomized controlled interventional study (purposive sampling method) done at Islam Teaching Hospital, Sialkot from 03-3-2021 to 11-8-2021 Methodology: Chairman Ethics Review Board, Islam Medical College, Sialkot vide letter No.2021-04/A, dated 03-3-2021, consented for study. G-power statistics v3.1.9.2, employing chi-square goodness of fit test value of 11.07, total sample was 144 bunched into two prophylactic treatment groups by using computer generated numbers (group-A, Inj. atropine 0.5mg and group-B, Inj. Placebo (control) planned for elective caesarean spinal delivery. Primary study variable being hemodynamic stability (pulse, blood pressure) in first 15 minutes after placing block. Independent-Samples Kruskal-Wallis Test used to compare systolic blood pressures between groups for association. Chi- square hypothesis test, was done with P-value <0.05 considered as statistically significant. SPSS analysis was done with v.21 Results: In Atropine group-A, there was rather a 11% increase in mean heart rate at 15 minutes mark (statistically significant) than the mean baseline value while in group-B (placebo)similar values parameter showed a 4.7% decline in mean heart rate value. In group-A, mean systolic blood pressure value declined only by 12.2% at 15 minutes mark from baseline value whereas in group-B, a decline of 13.2% was noted. Conclusion: Prophylactic bolus of atropine against un-opposed vagal activity provided stable hemodynamic values in cesarean spinal delivery