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Indian Journal of Anesthesia and Analgesia

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Comparison of Bolus Phenylephrine, Ephedrine and Mephentermine for the Management of Hypotension during Spinal Anaesthesia in Caesarean Section: A Clinical Study

Nama Nagarjuna Chakravarthy , Tejaswini Tadooru1 , Nama Nagarjuna Chakravarthy2

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Indian Journal of Anesthesia and Analgesia 7(1):p 361-367, January-February 2020. | DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.7120.49

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Tejaswini Tadooru, Nama Nagarjuna Chakravarthy. Comparison of Bolus Phenylephrine, Ephedrine and Mephentermine for the Management of Hypotension during Spinal Anaesthesia in Caesarean Section: A Clinical Study. Indian J Anesth Analg. 2020;7(1 Part -II):361-367.

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Received : N/A         Accepted : N/A          Published : N/A

Abstract

Background: The delivery of the infant into the arms of a conscious and pain free mother is one of the most exciting and rewarding moments in medicine. To compare the efficacy of vasopressors by measuring Systolic and Diastolic blood pressure, Heart rate, Nausea and Vomiting, Neonatal APGAR scores in all Three Groups. Methods: A Prospective comparative clinical study was conducted in 30 patients coming for elective lower segment Cesarean section. Parturients were divided into 3 Groups (P, E, M) of 30 each as per the study drugs. Patients meeting the criteria were incorporated into the study. Randomization achieved by sealed envelope technique. Patient’s height and weight were measured during the preanesthetic visit. Baseline values for maternal systolic blood pressure, diastolic blood pressure and heart rate were recorded. Epi-info 7 was used for analysis. Results: No statistically significant differences were found in all the 3 Groups with regards to baseline heart rate, baseline systolic blood pressure and baseline diastolic blood pressure. There was significant statistical difference in the total dose of Phenylephrine, Ephedrine and Mephentermine used (p < 0.05). No Significant differences were observed between heart rate changes in Ephedrine and Mephentermine group. Conclusion: Phenylephrine, Mephentermine and Ephedrine effectively maintained arterial blood pressure during spinal anesthesia for cesarean section. Phenylephrine has quicker onset and peak effect in comparison to ephedrine and mephentermine and its predictable carotid sinus reflex effect causes reduction in heart rate, which may be advantageous in cardiac patients and patients in whom tachycardia is undesirable.

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Tejaswini Tadooru, Nama Nagarjuna Chakravarthy. Comparison of Bolus Phenylephrine, Ephedrine and Mephentermine for the Management of Hypotension during Spinal Anaesthesia in Caesarean Section: A Clinical Study. Indian J Anesth Analg. 2020;7(1 Part -II):361-367.

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DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.7120.49

Keywords

Phenylephrine; Mephentermine; Ephedrine; Cesarean section; Vasopressor.

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