Phenylephrine versus ephedrine usage in the management of hypotension-induced spinal anaesthesia in pre-eclamptic patients undergoing caesarean section

Objective The aim of the current study is to assess and compare the effect of using phenylephrine and ephedrine for the prevention and treatment of maternal hypotension associated with induction of spinal anaesthesia in pre-eclamptic women undergoing a caesarean section. Study design This was a prospective randomized-controlled study. Patients and methods Sixty full-term pre-eclamptic patients, undergoing caesarean section under spinal anaesthesia, were divided into four groups: group 1 was administered 5 mg ephedrine intravenously and 5 mg boluses whenever there was maternal hypotension. Group 2 was administered 25 µg intravenous bolus phenylephrine and 25 µg boluses whenever there was maternal hypotension. Group 3 was administered a phenylephrine infusion at 25 µg/min; subsequently, the rate of infusion was adjusted according to systolic blood pressure (SBP). Group 4 was administered 15 ml/kg lactated ringer solution before spinal anaesthesia; subsequently, the rate of infusion was adjusted according to SBP. Results There was no statistically significant difference in the maternal heart rate changes, SBP changes, Doppler study of the uterine arteries, newborn blood pH and Apgar scores at 1 and 5 min between the four groups. Conclusion The use of an ephedrine or a phenylephrine infusion for the treatment of hypotension induced by spinal anaesthesia in pre-eclamptic patients yields comparable maternal and neonatal outcomes; further studies on a larger sample study are recommended to confirm our results.