EFFICACY OF INTRAMUSCULAR PHENYLEPHRINE FOR MAINTENANCE OF MATERNAL HEMODYNAMICS IN CAESAREAN SECTION UNDER SPINAL ANAESTHESIA
Objective: To determine the efficacy of intramuscular phenylephrine for maintenance of maternal hemodynamics in caesarean section under spinal anesthesia.
Study Design: Case series.
Place and Duration of Study: Department of Anesthesia, Combined Military Hospital Sialkot, from Nov 2017 to May 2018.
Methodology: Sixty women having C-section under spinal anesthesia were included after informed written consent. These patients received phenylephrine 5mg intramuscularly just after institution of spinal anesthesia. Outcome variable was change in mean heart rate and mean arterial pressure for 30 minutes following spinal anesthesia and frequency of spinal anesthesia induced hypotension. A predesigned proforma was used to record patient’s demographic details along with other study variables.
Results: The age of the patients ranged from 20 to 37 years with a mean of 28.3 ± 4.4 years. Immediately after the spinal anesthesia, the mean heart rate and mean of mean arterial pressure were 80.73 ± 5.082 beats per minute and 82.30 ± 4.820 mmHg respectively. There after there were only insignificant changes in the mean heart rate and mean of mean arterial pressure from baseline as shown by paired sample t-test (p-value>0.05). Only one patient developed hypotension after 4 minutes of spinal anesthesia and was successfully managed and her mean arterial pressure remained fairly stable thereafter.
Conclusion: Intramuscular phenylephrine (5 mg) given prophylactically was found to be effective in reducing the incidence of hypotension related to spinal anesthesia in patients undergoing lower segment caesarean section which along with fetomaternal safety profile recommends its use in future practice.