Comparison of norepinephrine with ephedrine boluses for the treatment of maternal hypotension during cesarean section under spinal anesthesia: A prospective observational study

IF 0.2 Q4 ANESTHESIOLOGY
Antima Phogat, Neeta Kavishvar
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Abstract

Spinal Induced Hypotension: Hypotension is one of the most common side effects of spinal anesthesia for lower segment cesarean section (LSCS). The most commonly used vasopressors for the treatment of spinal-induced hypotension (SIH) are phenylephrine, ephedrine, and norepinephrine. Aim: This study aimed to compare the efficacy of boluses of ephedrine and norepinephrine for the treatment of SIH in cesarean section. Methods and Material: A prospective observational study was conducted on 160 women undergoing elective and emergency cesarean section receiving spinal anesthesia with injection of bupivacaine heavily. Whenever hypotension (fall in systolic blood pressure (SBP) <20% from baseline value or SBP <80 mm Hg, whichever is less) occurred, either ephedrine (6 mg) or noradrenaline (6 μg) was given intravenous (IV) bolus as per the availability. Primary outcomes were maternal hemodynamic parameters, number of episodes of hypotension, requirement of bolus vasopressors, and Apgar score. Other outcomes were episodes of tachycardia, bradycardia, hypertension, and maternal side effects such as nausea, vomiting, shivering, and arrhythmia. Data analysis was performed with the help of Microsoft Excel and Statistical Package for the Social Sciences (SPSS) version 25. A P- value of <0.05 was considered statistically significant. Results: The mean SBP of both groups was comparable (P < 0.05). The mean heart rate (HR) was significantly higher in group E than in group N at 8 minutes and after till 60 minutes (P < 0.001). No statistical difference was found between the two groups in the Apgar score (P > 0.05). The mean dose requirement of ephedrine in group E was 1.94 and in group N was 2.04. Conclusions: Ephedrine (6 mg) and norepinephrine (6 μg) boluses are efficacious in treating hypotension after spinal anesthesia in obstetric patients. Norepinephrine appears to be favorable in view of HR than ephedrine.
去甲肾上腺素与麻黄碱丸治疗腰麻剖宫产术中产妇低血压的比较:一项前瞻性观察研究
脊髓诱导性低血压:低血压是下段剖宫产(LSCS)脊髓麻醉最常见的副作用之一。治疗脊髓性低血压(SIH)最常用的血管升压药是苯肾上腺素、麻黄碱和去甲肾上腺素。目的:比较麻黄素和去甲肾上腺素治疗剖宫产SIH的疗效。方法和材料:对160例接受选择性和紧急剖宫产手术的妇女进行了前瞻性观察研究,这些妇女接受了大量注射布比卡因的脊麻麻醉。无论何时低血压(收缩压下降0.05)。E组和N组的麻黄碱平均需要量分别为1.94和2.04。结论:麻黄素(6 mg)和去甲肾上腺素(6μg)丸治疗产科患者脊麻后低血压是有效的。从HR的角度来看,去甲肾上腺素似乎比麻黄碱更有利。
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37
审稿时长
29 weeks
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