A Comparison of Pre - Emptive Intramuscular Phenylphrine and Ephedrine in Prevension of Spinal Anaesthesia Induced Hypotension During Caesaerian Section

OBJECTIVE: sub arachnoid block is extensively used for the conduction of caesarean section without prophylactic measures; hypotension is a frequent occurrence (in about 80% of the patients). Hypotension is associated with distressing symptoms of dizziness, nausea and vomiting, and may also interfere with the surgical procedure. Present study is a comparison of pre-emptive intramuscular phenylephrine and ephedrine in prevention of spinal anesthesia induced hypotension during caesarian section. METHODS: In this randomized double blind, placebo controlled study, we have evaluated preemptive phenylephrine 2 mg IM; in comparison with ephedrine 45 mg IM and 2 ml saline given just after induction of spinal anesthesia, in terms of hemodynamic stability, development of symptoms like nausea and vomiting and requirement for rescue IV ephedrine vasopressor therapy in patients undergoing lower segment caesarean section. RESULTS: All the groups were comparable with respect to mean age, mean body weight MAP, and mean Pulse rate. In conclusion, pre-emptive use of intramuscular phenylephrine and ephedrine was found to be effective in prevention of spinal anesthesia induced hypotension, nausea and vomiting significantly. However, statistically no difference (p=0.351) was found between the phenylephrine and ephedrine group although the incidence of hypotension, nausea and vomiting was less in phenylephrine group. CONCLUSION: Phenylephrine group seems better to prevent incidence of hypotension, nausea and vomiting among all groups.