A Comparison between Prophylactic Bolus Dose of Norepinephrine versus Phenylephrine in Preventing Hypotension after Spinal Anesthesia in Caesarean Section.
Background: The spinal anesthesia is widely used in elective cesarean sections. Hypotension accompanying spinal anesthesia is frequently related with maternal and neonatal co-morbidities and many methods were explored to prevent hypotension like vasopressors.
Aim of study: To determine if an intravenous prophylactic bolus dose of norepinephrine is effective compared to an intravenous prophylactic bolus dose of phenylephrine in Preventing Hypotension after Spinal Anesthesia in Caesarean Section.
Patients and methods: A prospective randomized controlled clinical trial carried out in Obstetric Operation Room of Baghdad Teaching Hospital/Medical city complex during the period from November, 2017 to August, 2018 on convenient sample of 90 women undergone spinal anesthesia of cesarean section. The sample of women was randomized into three groups Phenylephrine (30 women), Norepinephrine (30 women) and Control (30 women). The number of rescue drugs, vital signs and side effects were recorded each 3 minutes from baseline to 48th minute.
Results: both norepinephrine (20 μg) and phenylephrine (100 μg) were effective in prevention of hypotension after spinal anesthesia but norepinephrine was slightly more significant in maintaining mean arterial pressure during the first 9 minutes after spinal anesthesia ( p value <0.001 in 3 and 6 minutes and 0.003 in 9 minutes ).
Conclusions: Both norepinephrine and phenylephrine were effective in prevention of hypotension after spinal anesthesia.
Keywords: Spinal anesthesia, Hypotension, Norepinephrine, Phenylephrine.