A comparative study of infusions of phenylephrine, ephedrine and phenylephrine plus ephedrine on maternal haemodynamics in elective caesarean section
Introduction: This randomized double blind study was started with an objective of management of spinal anaesthesia-induced hypotension in elective caesarean section by combining two commonly used vasopressors - ephedrine and phenylephrine in half of their usual doses with an expectation of reducing...
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Wolters Kluwer Medknow Publications
2011-01-01
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| Series: | Indian Journal of Anaesthesia |
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| Online Access: | http://www.ijaweb.org/article.asp?issn=0019-5049;year=2011;volume=55;issue=6;spage=578;epage=583;aulast=Das |
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| author | Sabyasachi Das Soma Mukhopadhyay Mohanchandra Mandal Sukanta Mandal Sekhar Ranjan Basu |
| author_facet | Sabyasachi Das Soma Mukhopadhyay Mohanchandra Mandal Sukanta Mandal Sekhar Ranjan Basu |
| author_sort | Sabyasachi Das |
| collection | DOAJ |
| description | Introduction: This randomized double blind study was started with an objective of management of spinal anaesthesia-induced hypotension in elective caesarean section by combining two commonly used vasopressors - ephedrine and phenylephrine in half of their usual doses with an expectation of reducing their foetomaternal side effects. Methods: One hundred and thirty two patients were randomized into three groups to receive either 100 mg/ml phenylephrine (group-P, n=31) or 3 mg/ml ephedrine (group-E, n=33) or 50 mg phenylephrine plus 1.5 mg ephedrine/ml (group-PE, n=29). Immediately after spinal injection the study solution was started prophylactically in every patient at the rate of 40 ml/h. A predefined algorithm was used to adjust the infusion rate according to the systolic blood pressure (SBP). Results: Mean fall of SBP was significantly more in group-E than group-P (P=0.009) and group-PE (P=0.013). This was not significantly different when compared between group-P and group-PE (P=0.9). Episodes of hypotension and tachycardia were more in group-E than the other two groups. Statistically significant tachycardia was seen in Group-E than that in other two groups. Incidence of bradycardia and hypertension did not differ significantly among the groups. Maternal nausea and Apgar score were also comparable in three groups. Conclusion: Current study claims that prophylactic phenylephrine 100 mg/ml is a better choice than ephedrine (3 mg/ml) or 50 mcg phenylephrine plus 1.5 mg ephedrine/ml in prevention of spinal anaesthesia-induced hypotension in elective caesarean section. Combination of two drugs in half the usual dose has no added advantage over phenylephrine, but this is better than ephedrine alone. |
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| issn | 0019-5049 |
| language | English |
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| publishDate | 2011-01-01 |
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| series | Indian Journal of Anaesthesia |
| spelling | doaj.art-870edb32512c4e71a0dec822a4cba9632022-12-21T20:44:12ZengWolters Kluwer Medknow PublicationsIndian Journal of Anaesthesia0019-50492011-01-0155657858310.4103/0019-5049.90612A comparative study of infusions of phenylephrine, ephedrine and phenylephrine plus ephedrine on maternal haemodynamics in elective caesarean sectionSabyasachi DasSoma MukhopadhyayMohanchandra MandalSukanta MandalSekhar Ranjan BasuIntroduction: This randomized double blind study was started with an objective of management of spinal anaesthesia-induced hypotension in elective caesarean section by combining two commonly used vasopressors - ephedrine and phenylephrine in half of their usual doses with an expectation of reducing their foetomaternal side effects. Methods: One hundred and thirty two patients were randomized into three groups to receive either 100 mg/ml phenylephrine (group-P, n=31) or 3 mg/ml ephedrine (group-E, n=33) or 50 mg phenylephrine plus 1.5 mg ephedrine/ml (group-PE, n=29). Immediately after spinal injection the study solution was started prophylactically in every patient at the rate of 40 ml/h. A predefined algorithm was used to adjust the infusion rate according to the systolic blood pressure (SBP). Results: Mean fall of SBP was significantly more in group-E than group-P (P=0.009) and group-PE (P=0.013). This was not significantly different when compared between group-P and group-PE (P=0.9). Episodes of hypotension and tachycardia were more in group-E than the other two groups. Statistically significant tachycardia was seen in Group-E than that in other two groups. Incidence of bradycardia and hypertension did not differ significantly among the groups. Maternal nausea and Apgar score were also comparable in three groups. Conclusion: Current study claims that prophylactic phenylephrine 100 mg/ml is a better choice than ephedrine (3 mg/ml) or 50 mcg phenylephrine plus 1.5 mg ephedrine/ml in prevention of spinal anaesthesia-induced hypotension in elective caesarean section. Combination of two drugs in half the usual dose has no added advantage over phenylephrine, but this is better than ephedrine alone.http://www.ijaweb.org/article.asp?issn=0019-5049;year=2011;volume=55;issue=6;spage=578;epage=583;aulast=DasBradycardiaelective caesarean sectionhypotensionspinal anaesthesiavasopressors |
| spellingShingle | Sabyasachi Das Soma Mukhopadhyay Mohanchandra Mandal Sukanta Mandal Sekhar Ranjan Basu A comparative study of infusions of phenylephrine, ephedrine and phenylephrine plus ephedrine on maternal haemodynamics in elective caesarean section Indian Journal of Anaesthesia Bradycardia elective caesarean section hypotension spinal anaesthesia vasopressors |
| title | A comparative study of infusions of phenylephrine, ephedrine and phenylephrine plus ephedrine on maternal haemodynamics in elective caesarean section |
| title_full | A comparative study of infusions of phenylephrine, ephedrine and phenylephrine plus ephedrine on maternal haemodynamics in elective caesarean section |
| title_fullStr | A comparative study of infusions of phenylephrine, ephedrine and phenylephrine plus ephedrine on maternal haemodynamics in elective caesarean section |
| title_full_unstemmed | A comparative study of infusions of phenylephrine, ephedrine and phenylephrine plus ephedrine on maternal haemodynamics in elective caesarean section |
| title_short | A comparative study of infusions of phenylephrine, ephedrine and phenylephrine plus ephedrine on maternal haemodynamics in elective caesarean section |
| title_sort | comparative study of infusions of phenylephrine ephedrine and phenylephrine plus ephedrine on maternal haemodynamics in elective caesarean section |
| topic | Bradycardia elective caesarean section hypotension spinal anaesthesia vasopressors |
| url | http://www.ijaweb.org/article.asp?issn=0019-5049;year=2011;volume=55;issue=6;spage=578;epage=583;aulast=Das |
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