Appraisal of the Effect of Norepinephrine Versus Phenylephrine on Blood Pressure and Heart Rate During Spinal Anaesthesia for a Caesarean Section; A Quasi-Experimental Study

Authors

  • Hina Iftikhar Combined Military Hospital, Multan/National University of Medical Sciences (NUMS), Pakistan
  • Ali Hassan Combined Military Hospital, Multan/National University of Medical Sciences (NUMS), Pakistan
  • Habib Ur Rehman Combined Military Hospital, Multan/National University of Medical Sciences (NUMS), Pakistan
  • Saeed Bin Ayaz Combined Military Hospital, Muzaffarabad /National University of Medical Sciences (NUMS), Pakistan
  • Zulfiqar Ali Combined Military Hospital, Multan/National University of Medical Sciences (NUMS), Pakistan
  • Kaukab Majeed Pak Emirates Military Hospital/National University of Medical Sciences (NUMS), Rawalpindi Pakistan

DOI:

https://doi.org/10.51253/pafmj.v72i4.7674

Keywords:

Bradycardia, Hypotension, Spinal anaesthesia

Abstract

Objectives: To compare the effects of Norepinephrine and Phenylephrine on blood pressure and heart rate during spinal anaesthesia for caesarean section.

Study Design: Quasi-experimental study.

Place and Duration of Study: Department of Anaesthesia Combined Military Hospital, Multan Pakistan, from May to Nov 2019.

Methodology: Women (age: 18 to 45 years) with singleton pregnancy planned for caesarean section in spinal anaesthesia were included. Women with pregnancy-induced hypertension, placenta previa, placenta accreta, diabetes mellitus, and any other cardiovascular disease were excluded. After distribution into groups, Group-A was given a 20μg Norepinephrine bolus, and Group-B was given a 50μg bolus of Phenylephrine just after spinal anaesthesia. At five time points, systolic, diastolic, and mean blood pressures and heart rate were measured: baseline, block of the highest sensory level, oxytocin injection, delivery, and operation completion. If hypotension developed, the same rescue drug was repeated. Bradycardia was countered by 0.5 mg of Atropine.

Results: The frequency of hypotension in the Norepinephrine group was 5 (16.67%), and in the Phenylephrine Group, it was 19 (63.33%) (p=0.0001). The frequency of bradycardia in the Norepinephrine Group was 6 (20%), and in the Phenylephrine Group, it was 17 (56.67%) (p=0.003).

Conclusion: The frequency of hypotension and bradycardia is less after prophylactic 20 μg of Norepinephrine during spinal anaesthesia for a caesarean section than 50 μg of Phenylephrine.

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Published

26-09-2022

Issue

Section

Original Articles

How to Cite

1.
Iftikhar H, Hassan A, Rehman HU, Ayaz SB, Ali Z, Majeed K. Appraisal of the Effect of Norepinephrine Versus Phenylephrine on Blood Pressure and Heart Rate During Spinal Anaesthesia for a Caesarean Section; A Quasi-Experimental Study. Pak Armed Forces Med J [Internet]. 2022 Sep. 26 [cited 2024 Jul. 19];72(4):1324-28. Available from: https://pafmj.org/PAFMJ/article/view/7674