scholarly journals Potency of Mephentermine for Prevention of Post-spinal Hypotension

2009 ◽  
Vol 37 (4) ◽  
pp. 568-570 ◽  
Author(s):  
M. Mohta ◽  
D. Agarwal ◽  
L. K. Gupta ◽  
A. K. Sethi ◽  
A. Tyagi
Keyword(s):  
Caesarean Section ◽  
Confidence Interval ◽  
Effective Dose ◽  
Initial Dose ◽  
Elective Caesarean Section ◽  
Dose Interval ◽  
Minimum Effective Dose ◽  
Potency Ratio ◽  
Sequential Allocation ◽  
Spinal Hypotension

This study was designed to determine the minimum effective dose (ED50) of mephentermine for prevention of post-spinal hypotension in women undergoing elective caesarean section. Dixon's up-down method of sequential allocation was used to determine the patient's dose of vasopressor drug. In our previous study, mephentermine appeared to be much more potent than ephedrine, so the present study was conducted using a lower initial dose and smaller dose interval for this vasopressor. Following administration of spinal anaesthesia, a prophylactic infusion of mephentermine was started with 5 mg infused over a period of 30 minutes as the initial dose and a dose interval of 1 mg. The ED50 of mephentermine of 3.7 mg (95% confidence interval 2.4 to 5.7 mg) was much less than that of ephedrine, as calculated in our previous study using the same methodology. Using these values gives a potency ratio of ephedrine to mephentermine of 1:6.8 (95% confidence interval 6.0 to 7.5).

scholarly journals Fluid loading therapy to prevent spinal hypotension in women undergoing elective caesarean section

2020 ◽  
Vol 37 (12) ◽  
pp. 1126-1142
Author(s):  
Koen Rijs ◽  
Frédéric J. Mercier ◽  
D. Nuala Lucas ◽  
Rolf Rossaint ◽  
Markus Klimek ◽  
...  
Keyword(s):  
Caesarean Section ◽  
Elective Caesarean Section ◽  
Fluid Loading ◽  
Spinal Hypotension

Relative Analgesic Potencies of Ropivacaine and Bupivacaine for Epidural Analgesia in Labor 

1999 ◽  
Vol 90 (4) ◽  
pp. 944-950 ◽  
Author(s):  
Linda S. Polley ◽  
Malachy O. Columb ◽  
Norah N. Naughton ◽  
Deborah S. Wagner ◽  
Cosmas J. M. van de Ven
Keyword(s):  
Confidence Interval ◽  
Epidural Analgesia ◽  
Analgesic Efficacy ◽  
Potency Ratio ◽  
Pain Scores ◽  
Epidural Bupivacaine ◽  
Sequential Allocation ◽  
Motor Effects ◽  
Double Blinded ◽  
First Stage Of Labor

Background The minimum local analgesic concentration (MLAC) has been defined as the median effective local analgesic concentration in a 20-ml volume for epidural analgesia in the first stage of labor. The aim of this study was to assess the relative analgesic potencies of epidural bupivacaine and ropivacaine by determining their respective minimum local analgesic concentrations. Methods Seventy-three parturients at < or = 7 cm cervical dilation who requested epidural analgesia were allocated to one of two groups in this double-blinded, randomized, prospective study. After a lumbar epidural catheter was placed, 20 ml of the test solution was given, either ropivacaine (n = 34) or bupivacaine (n = 39). The concentration of local anesthetic was determined by the response of the previous patient in that group to a higher or lower concentration using up-down sequential allocation. Analgesic efficacy was assessed using 100-mm visual analog pain scores with < or = 10 mm within 30 min defined as effective. An effective result directed a 0.01% wt/vol decrement for the next patient. An ineffective result directed a 0.01% wt/vol increment. Results The minimum local analgesic concentration of ropivacaine was 0.111% wt/vol (95% confidence interval, 0.100-0.122), and the minimum local analgesic concentration of bupivacaine was 0.067% wt/vol (95% confidence interval, 0.052-0.082). Ropivacaine was significantly less potent than bupivacaine, with a potency ratio of 0.6 (95% confidence interval, 0.49-0.74). No difference in motor effects was observed. Conclusion Ropivacaine was significantly less potent than bupivacaine for epidural analgesia in the first stage of labor.

scholarly journals A Comparative Study to Evaluate the Effect of Norepinephrine and Phenylephrine in the Treatment of Post Spinal Hypotension for Caesarean Section

2022 ◽  
Author(s):  
Archita Patil ◽  
Rashmee Chavan ◽  
Shwetha K. Mudalagirigowda ◽  
Sravya Adda
Keyword(s):  
Caesarean Section ◽  
Spinal Anaesthesia ◽  
Elective Caesarean Section ◽  
Fluid Loading ◽  
Time Intervals ◽  
Induced Hypotension ◽  
Cardiovascular Side Effects ◽  
Blinded Study ◽  
Spinal Hypotension ◽  
Double Blinded

Background: Maternal hypotension due to spinal anaesthesia in caesarean section is commonly seen. Alongwith fluid loading, phenylephrine is used to manage the hypotension. However, this drug is associated with cardiovascular side effects. Methods: This is a prospective double blinded study which was conducted on 100 term parturients scheduled from elective caesarean section under spinal anaesthesia, randomly assigned into two groups. After spinal anaesthesia patients of group N and P were treated with norepinephrine (5mcg) and phenylephrine (50mcg) respectively as an IV bolus for hypotension. Blood pressure, heart rate, number of bolus doses given, and neonatal APGAR score was noted. Results:  Patients of both groups were comparable with respect to haemodynamic parameters (HR, SBP, DBP, AND MAP). Incidence of bradycardia was higher in group P (22%, n=11) compared to group N (14%, n=7). Neonatal APGAR scores at different time intervals were similar in both groups. Conclusion: Intermittent boluses of norepinephrine were effective in the treatment of spinal anaesthesia induced hypotension during caesarean section and can be considered as an alternative to phenylephrine.

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