Pakistan Armed Forces Medical Journal (Jun 2020)
COMPARISON OF VARIABLE RATE PHENYLEPHRINE INFUSION WITH RESCUE PHENYLEPHRINE BOLUSES VERSUS RESCUE BOLUSES ALONE FOR PREVENTION OF HYPOTENSION DURING SPINAL ANESTHESIA FOR ELECTIVE CESAREAN DELIVERY
Abstract
Objective: To compare effectiveness of infusion with phenylephrine plus rescue boluses and rescue boluses in preventing frequency of maternal hypotension in patients undergoing cesarean section under spinal anesthesia. Study Design: Quasi experimental study. Place and Duration of Study: Anesthesia Department, Holy Family Hospital Rawalpindi, from Nov 2015 to May 2016. Methodology: A total of 80 patients were randomly divided using lottery method in group A and B. Spinal anesthesia was given with co-loading as 15 ml/kg of ringer lactate, with 12mg of hyperbaric bupivacaine (0.75%). No pre-medication was used. Patients received variable amount phenylephrine infusion starting at 0.75μg/kg/ min (group A) or variable rate prophylactic saline infusion at 0.0075ml/kg/min (group B) (control group). Maternal hypotension was treated with rescue boluses of phenylephrine (50-100μg). Results: Mean age was 30 ± 2.23years’ vs. 31± 2.81 years (group A Vs group B) (p=0.0818). The two groups did not differ in American society of Anaesthesiologists ASA status. Mean BMI in group A and group B was 24 ± 2.813 vs. 25 ± 3.114 (p=0.1358). Mean NIBP in group A and group B was 110/70mm Hg ± 8.62 vs. 111/80mm Hg ± 10.224 (p=0.6376). Phenylephrine infusion with rescue boluses was operational in 32 (80%) subjects (there was less incidence of maternal hypotension) compared to boluses only was efficacious in 14 (35%) of all patients p<0.001. Conclusion: Our study concluded that phenylephrine infusion with rescue boluses provided better control of blood pressure than rescue boluses alone during cesarean section under spinal anesthesia.
