Norepinephrine Versus Phenylephrine for the Prevention of Post Spinal Hypotension in Caesarean Section.

Background: Hypotension following spinal anesthesia in the cesarean section is common despite adequate fluid loading. The recommended medication to treat spinal hypotension during cesarean section is phenylephrine. Norepinephrine bolus has recently been proposed as an alternative to phenylephrine b...

Full description

Bibliographic Details
Main Authors: Nabin Thapa, Pradip Raj Vaidya, Sangeeta Shrestha, Sabina Thapa
Format: Article
Language:English
Published: Karnali Academy of Health Sciences 2022-08-01
Series:Journal of Karnali Academy of Health Sciences
Subjects:
Online Access:http://jkahs.org.np/jkahs/index.php/jkahs/article/view/640
_version_ 1827777984482770944
author Nabin Thapa
Pradip Raj Vaidya
Sangeeta Shrestha
Sabina Thapa
author_facet Nabin Thapa
Pradip Raj Vaidya
Sangeeta Shrestha
Sabina Thapa
author_sort Nabin Thapa
collection DOAJ
description Background: Hypotension following spinal anesthesia in the cesarean section is common despite adequate fluid loading. The recommended medication to treat spinal hypotension during cesarean section is phenylephrine. Norepinephrine bolus has recently been proposed as an alternative to phenylephrine bolus. Our study's objective was to evaluate the efficacy of bolus doses of phenylephrine and norepinephrine in treating spinal-induced hypotension after cesarean delivery. Methods: One hundred and eighty parturient, ASA II, aged above 18 years, planning an elective cesarean section under anesthesia were randomly assigned by the lottery method into the two groups. Group P received Phenylephrine 50 µg intravenous bolus, and Group N received 5 µg of Norepinephrine intravenous bolus to prevent spinal-induced hypotension. Results: The incidence of hypotension after the prophylactic bolus dose of study drugs was 25.6% in group N and 32.2% in group P. The number of rescue bolus doses of the studied drug that were required to treat hypotension was lower in Group N than in group P (25.6% vs 32.2 % ). The Mephentermine that was required to treat hypotension was also lower in Group N than in Group P (11.1% vs 12.2 % ). The changes in heart rate and mean arterial pressure after the injection of the study drug were comparable. Conclusion: Prophylactic Norepinephrine and Phenylephrine bolus dose were equally effective in the prevention of spinal-induced hypotension during cesarean section.
first_indexed 2024-03-11T14:25:47Z
format Article
id doaj.art-fad9bdd1ede745e7a0986f1016e71174
institution Directory Open Access Journal
issn 2616-0064
2676-1327
language English
last_indexed 2024-03-11T14:25:47Z
publishDate 2022-08-01
publisher Karnali Academy of Health Sciences
record_format Article
series Journal of Karnali Academy of Health Sciences
spelling doaj.art-fad9bdd1ede745e7a0986f1016e711742023-10-31T15:30:41ZengKarnali Academy of Health SciencesJournal of Karnali Academy of Health Sciences2616-00642676-13272022-08-0152Norepinephrine Versus Phenylephrine for the Prevention of Post Spinal Hypotension in Caesarean Section.Nabin Thapa0Pradip Raj Vaidya1Sangeeta Shrestha2Sabina Thapa3KAHSDepartment of anesthesiology and intensive care, National Academy of Medical sciences,  Bir  HospitalMahabouddha, Kathmandu, Nepal, Department of anesthesiology,  Paropakar Maternity & Women’s Hospital, Thapathali, Kathmandu Nepal,School of  Nursing and Midwifery, Karnali Academy of Health Sciences,  Jumla, Nepal Background: Hypotension following spinal anesthesia in the cesarean section is common despite adequate fluid loading. The recommended medication to treat spinal hypotension during cesarean section is phenylephrine. Norepinephrine bolus has recently been proposed as an alternative to phenylephrine bolus. Our study's objective was to evaluate the efficacy of bolus doses of phenylephrine and norepinephrine in treating spinal-induced hypotension after cesarean delivery. Methods: One hundred and eighty parturient, ASA II, aged above 18 years, planning an elective cesarean section under anesthesia were randomly assigned by the lottery method into the two groups. Group P received Phenylephrine 50 µg intravenous bolus, and Group N received 5 µg of Norepinephrine intravenous bolus to prevent spinal-induced hypotension. Results: The incidence of hypotension after the prophylactic bolus dose of study drugs was 25.6% in group N and 32.2% in group P. The number of rescue bolus doses of the studied drug that were required to treat hypotension was lower in Group N than in group P (25.6% vs 32.2 % ). The Mephentermine that was required to treat hypotension was also lower in Group N than in Group P (11.1% vs 12.2 % ). The changes in heart rate and mean arterial pressure after the injection of the study drug were comparable. Conclusion: Prophylactic Norepinephrine and Phenylephrine bolus dose were equally effective in the prevention of spinal-induced hypotension during cesarean section. http://jkahs.org.np/jkahs/index.php/jkahs/article/view/640Caesarean sectionHypotensionNorepinephrinePhenylephrinespinalvasopressor
spellingShingle Nabin Thapa
Pradip Raj Vaidya
Sangeeta Shrestha
Sabina Thapa
Norepinephrine Versus Phenylephrine for the Prevention of Post Spinal Hypotension in Caesarean Section.
Journal of Karnali Academy of Health Sciences
Caesarean section
Hypotension
Norepinephrine
Phenylephrine
spinal
vasopressor
title Norepinephrine Versus Phenylephrine for the Prevention of Post Spinal Hypotension in Caesarean Section.
title_full Norepinephrine Versus Phenylephrine for the Prevention of Post Spinal Hypotension in Caesarean Section.
title_fullStr Norepinephrine Versus Phenylephrine for the Prevention of Post Spinal Hypotension in Caesarean Section.
title_full_unstemmed Norepinephrine Versus Phenylephrine for the Prevention of Post Spinal Hypotension in Caesarean Section.
title_short Norepinephrine Versus Phenylephrine for the Prevention of Post Spinal Hypotension in Caesarean Section.
title_sort norepinephrine versus phenylephrine for the prevention of post spinal hypotension in caesarean section
topic Caesarean section
Hypotension
Norepinephrine
Phenylephrine
spinal
vasopressor
url http://jkahs.org.np/jkahs/index.php/jkahs/article/view/640
work_keys_str_mv AT nabinthapa norepinephrineversusphenylephrineforthepreventionofpostspinalhypotensionincaesareansection
AT pradiprajvaidya norepinephrineversusphenylephrineforthepreventionofpostspinalhypotensionincaesareansection
AT sangeetashrestha norepinephrineversusphenylephrineforthepreventionofpostspinalhypotensionincaesareansection
AT sabinathapa norepinephrineversusphenylephrineforthepreventionofpostspinalhypotensionincaesareansection