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Evaluation of Pre-emptive Intramuscular Glycopyrrolate in Prevention of Spinal Anesthesia Induced Hypotension in Elective Cesarean Sections

Dinesh Krishnamurthy , Abhinaya Manem1 , Dinesh Krishnamurthy2

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Indian Journal of Anesthesia and Analgesia 6(3):p 705-712, May-June 2019. | DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.6319.2

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Abhinaya Manem, Dinesh Krishnamurthy. Evaluation of Pre-emptive Intramuscular Glycopyrrolate in Prevention of Spinal Anesthesia Induced Hypotension in Elective Cesarean Sections. Indian J Anesth Analg. 2019;6(3):705-711.

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

Abstract

Context: Spinal anesthesia induced hypotension in parturients undergoing Cesarean section can be detrimental to both foetus and mother. Prophylactic administration of vasopressors helps in preventing hypotension thereby maintaining the uteroplacental blood flow. Aims: The main objective of this study is to determine whether prophylactic intramuscular Glycopyrrolate administration reduces the incidence and severity of hypotension associated with spinal anesthesia in parturients. Settings and Design: Randomized double blinded prospective study. Methods and Material: Sixty parturients scheduled for elective LSCS under spinal anesthesia were randomly allocated into two groups of 30 each, Group G who received intramuscular glycopyrrolate 0.2 mg (1 ml) and Group S who received intramuscular saline (1 ml), 15 minutes prior to subarachnoid block. Incidence and severity of hypotension, heart rate and blood pressure changes, incidence of nausea and vomiting were observed. Statistical analysis used: Chi-square test was used for qualitative data and for Continuous data, mean and standard deviation. SPSS 22 software was used. Results: Thirteen out of thirty parturients (43.3%) had hypotension in glycopyrrolate group whereas 22 out of 30 parturients (73%) developed hypotension in saline group with a p value of 0.018. The median dose of vasopressor requirement was less in glycopyrrolate group when compared to saline group (0 vs 6 mg). Conclusions: Pre-emptive treatment with intramuscular glycopyrrolate reduces the incidence and severity of hypotension in parturients undergoing Cesarean sections under spinal anesthesia.

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Abhinaya Manem, Dinesh Krishnamurthy. Evaluation of Pre-emptive Intramuscular Glycopyrrolate in Prevention of Spinal Anesthesia Induced Hypotension in Elective Cesarean Sections. Indian J Anesth Analg. 2019;6(3):705-711.

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DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.6319.2

Keywords

Glycopyrrolate; Hypotension; Subarachnoid block.

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