The effectiveness of noradrenaline for preventing hypotension during spinal anesthesia for cesarean delivery

Abstract

Background: Spinal anesthesia-induced hypotension is a common complication which can cause many severe maternal and fetal consequences. Therefore, the prevention and treatment of this complication play an important role. The vasopressor recently suggested to prevent hypotension during spinal anesthesia has been noradrenaline. The aim of this study is to evaluate the efficacy and side effects of noradrenaline intravenous transfusion and bolus for prevention of spinal anesthesia-induced hypotension during cesarean delivery. Methods: In the randomized controlled study, 110 pregnants undergoing cesarean delivery with spinal anesthesia were randomly divided into two groups: Group T: noradrenaline transfusion at a dose of 0.05 μg/kg/min (n = 55), and group B: noradrenaline intravenous injection 6 μg (n = 55). Both groups were recorded the incidence of hypotension, levels of hypotension, maternal side effects and neonatal APGAR scores at 1 and 5 minutes. Results: Four parturients in group B were excluded from the study due to the failure of spinal anesthesia. Maternal hypotension and level of hypotension of 20 - 30% of baseline systolic blood tension were less frequent in group T than in group B. The level of hypotension above 30% of baseline systolic blood tension and maternal side effects in both groups were low and comparable. The neonatal APGAR scores at 1 minute and 5 minutes in both groups were ≥ 8 and ≥ 9 respectively… Conclusion: Noradrenaline prophylactic infusion at dose of 0.05 μg/kg/min was more effective than noradrenaline intravenous bolus of 6 μg for maintaining blood pressure and decreasing the incidence of hypotension, level of hypotension. In addition, both groups of prophylactic noradrenaline didn’t cause detrimental adverses for parturients and their babies. Key words: hypotensive prophylaxis, cesarean delivery, noradrenaline.