scholarly journals Can propofol procedural sedation implementation increase the acceptance of spinal anesthesia during cesarean section?

2019 ◽  
Vol 11 (1) ◽  
Author(s):  
Alaa Mazy ◽  
Nadia Madkour ◽  
Hesham Shaalan
Keyword(s):  
Cesarean Section ◽  
Spinal Anesthesia ◽  
Acceptance Rate ◽  
Procedural Sedation ◽  
Chi Square ◽  
Mean Values ◽  
Patient’S Satisfaction ◽  
High Satisfaction ◽  
The Mean ◽  
Marked Relief

Abstract Background Parturients are highly anxious preoperatively. The worries of spinal anesthesia may preclude its acceptance despite being recommended. Procedural sedation is not a routine during regional blocks, but it is sensible that anesthesiologists should provide their blocks comfortably. The proposal is that implementing the propofol procedural sedation (PPS) may increase the acceptance rate of spinal anesthesia for cesarean section. Methods In this prospective observational study, the patients who refused spinal anesthesia primarily were interrogated to implement PPS for painless comfortable spinal anesthesia. Their acceptance rate was the primary outcome. In the sitting position, propofol 0.7 mg/kg and 20 mg increments were used as required. Patients were well supported and monitored. Data were compared by Mann-Whitney, chi-square, Fisher’s exact, and Friedman’s ANOVA tests as appropriate. Results The acceptance rate of spinal anesthesia increased from 17 to 93%. During PPS, the mean values of minimal mean blood pressure were not significantly decreased, while the mean values of the heart rate slightly increased. The minimal values of oxygen saturation showed no significant reduction compared to the basal values. Patients expressed a marked relief of anxiety and high satisfaction. Conclusion The use of propofol procedural sedation was effective in increasing the acceptance rate of spinal anesthesia during CS with safety and high patient’s satisfaction.

scholarly journals Perbandingan Efektivitas Anestesi Spinal dengan Bupivacain 12,5 Mg dan Bupivacain 5 Mg yang ditambah Fentanyl 50 Mcg pada Seksio Sesarea

2021 ◽  
Vol 4 (1) ◽  
pp. 11-7
Author(s):  
Fritzky Indradata ◽  
Heri Dwi Purnomo ◽  
Muh. Husni Thamrin ◽  
Sugeng Budi Santoso ◽  
Ardana Tri Arianto ◽  
...  
Keyword(s):  
Side Effects ◽  
Cesarean Section ◽  
Spinal Anesthesia ◽  
Randomized Control Trial ◽  
Hyperbaric Bupivacaine ◽  
Chi Square ◽  
Double Blind ◽  
Duration Of Action ◽  
Significant Difference ◽  
Randomized Control

Latar Belakang: Anestesi spinal mempunyai efek samping berupa hipotensi dan mual muntah. Tujuan: penelitian ini adalah membandingkan efek anestesi spinal bupivacain dosis normal 12,5 mg dan bupivacain dosis rendah 5 mg dengan fentanyl 50 mg pada seksio sesarea terhadap perubahan hemodinamik, ketinggian blok, onset, durasi dan efek samping. Subjek dan Metode: Penelitian double blind randomized control trial pada 36 pasien yang memenuhi kriteria. Pasien dibagi menjadi dua kelompok, yang masing-masing terdiri 18 pasien, kelompok 1 dilakukan anestesi spinal dengan bupivacain hiperbarik 5 mg ditambah adjuvan fentanyl 50 mcg, sedangkan kelompok 2 diberikan bupivacain hiperbarik 12,5 mg. Penilaian meliputi saat mula kerja blokade sensorik, mula kerja blokade motorik, durasi, tekanan darah, laju nadi, dan saturasi oksigen, lama kerja dan efek samping. Data hasil penelitian diuji secara statistik dengan uji chi-square. Hasil: Terdapat perbedaan signifikan pada onset dan durasi blokade sensorik dan motorik, bupivacain 12,5 mg lebih baik dibandingkan bupivacain 5 mg + fentanyl 50 mcg (p<0.05). Tidak ada perbedaan signifikan pada perubahan tanda vital dan efek samping (p>0.05). Simpulan: Bupivacain 12,5 mg menghasilkan onset lebih cepat dan durasi lebih lama dibandingkan bupivacain 5 mg + fentanil 50 mcg pada anestesi spinal untuk seksio sesarea   Comparison of The Effectiveness Spinal Anesthesia with Bupivacaine 12,5 Mg and Bupivacaine 5 Mg added Fentanyl 50 Mcg in Caesarean Section Abstract Background: Spinal anesthesia has side effects such as hypotension and nausea and vomiting. Objective: The aim of this study was to compare the effects of spinal anesthesia with normal doses of 12,5 mg of bupivacaine and 5 mg of low-dose bupivacaine with fentanyl 50 mg in the cesarean section on hemodynamic changes, block height, onset, duration, and side effects. Subjects and Methods: Double-blind randomized control trial in 36 patients who met the criteria. Patients were divided into two groups, each consisting of 18 patients, group 1 underwent spinal anesthesia with 5 mg of hyperbaric bupivacaine plus 50 mcg of fentanyl adjuvant, while group 2 was given 12,5 mg of hyperbaric bupivacaine. Assessments include the initiation of sensory block action, onset of motor block action, duration, blood pressure, pulse rate, and oxygen saturation, duration of action, and side effects. The research data were statistically tested with the chi-square test. Results: There were significant differences in the onset and duration of sensory and motor blockade, bupivacaine 12,5 mg was better than bupivacaine 5 mg + fentanyl 50 mcg (p <0.05). There was no significant difference in changes in vital signs and side effects (p> 0.05). Conclusion: Bupivacaine 12,5 mg resulted in a faster onset and longer duration than bupivacaine 5 mg + fentanyl 50 mcg in spinal anesthesia for cesarean section.

scholarly journals Effect of ondansetron on spinal induced hypotension in caesarean deliveries

2020 ◽  
Vol 8 (4) ◽  
pp. 193-199
Author(s):  
Pujan Balla ◽  
Anil Shrestha ◽  
Ninadini Shrestha ◽  
Navindra Bista ◽  
Moda Nath Marhatta
Keyword(s):  
Spinal Anesthesia ◽  
Elective Caesarean Section ◽  
P Value ◽  
Chi Square ◽  
Induced Hypotension ◽  
Intergroup Comparison ◽  
Chi Square Test ◽  
The Mean ◽  
Student’S T ◽  
Student’S T Test

Background: Spinal anesthesia is the preferred technique of anesthesia employed for caesarean sections. However, it is very often complicated by hypotension. Different drugs and techniques have been used to prevent the hypotension induced by spinal anesthesia. In this study, the effect of ondansetron on the prevention of hypotension after spinal anesthesia was evaluated. Objectives: To determine the effect of prophylactic ondansetron on prevention of spinal induced hypotension in elective caesarean section. Methodology: Eighty-six parturients planned for elective caesarean deliveries were randomized into two groups of 43 each. Group O received Ondansetron 4 mg (4 ml) and Group S received Normal Saline (4 ml) intravenously 10 minutes prior to spinal anesthesia. Blood pressure, heart rate, phenylephrine requirements, occurrence of nausea and vomiting and APGAR scores of neonates were compared between the groups. Hemodynamic data was analyzed using Student’s t-test for intergroup comparison and ANOVA was used for intragroup comparison. Categorical data was analyzed using Pearson Chi-Square test. For all determinants, p-value <0.05 was considered significant. Results: Occurrence of hypotension in Group O (20.9 %) was significantly lower than in Group S (72.1%) (p < 0.05). The mean arterial pressure was significantly higher in Group O at 2, 6, 8, 12 and 14 minutes (p < 0.05). The use of phenylephrine (37.21 mcg vs. 146.51 mcg, p < 0.05) and occurrence of nausea (11.6%, vs. 41.9% p < 0.002) was significantly lower in ondansetron group. Conclusion: Ondansetron is effective in preventing spinal induced hypotension in elective caesarean sections.

scholarly journals Incidence of Post-spinal Hypotension during Cesarean Section in Paropakar Maternity and Women’s Hospital

2018 ◽  
Vol 13 (3) ◽  
pp. 43-47
Author(s):  
Sangeeta Shrestha ◽  
Tara Gurung ◽  
Ritu Pradhan ◽  
Amir Babu Shrestha
Keyword(s):  
Cesarean Section ◽  
Spinal Anesthesia ◽  
Demographic Data ◽  
Loss Of Consciousness ◽  
Cardiovascular Collapse ◽  
Prophylactic Measures ◽  
The Mean ◽  
Spinal Hypotension ◽  
Record Section ◽  
Very High

Aims: Spinal anesthesia is the choice of anesthesia in parturient for cesarean section. This procedure is frequently associated with hypotension and the incidence varies from 70% to 80%. Maternal hypotension causes very unpleasant sign and symptoms such as nausea, vomiting, dyspnoea and sense of impending doom. Prolonged episodes of hypotension lead to organ ischemia, loss of consciousness, cardiovascular collapse and uteroplacental hypoperfusion. The aim of this study is to find out the proper data of the incidence of hypotension in parturient undergoing cesarean section in our hospital as only the estimated data is present. Methods: We retrospectively reviewed the intraoperative anesthesia record form of all the patients who underwent cesarean section under spinal anesthesia from the hospital record section from 13th April 2016 to 12th April 2017. The detailed parameters of patient’s demographic data were collected and recorded. Results: A total of 3814 parturients were included in this study. The mean age was 25.76 ± 4.74 years and mean gestational age was 39.23 ± 1.54 weeks. Post spinal hypotension was seen in 947 patients out of 3814. Thus the incidence of hypotension was 24.8%. Conclusions: The incidence of maternal hypotension is very high if prophylactic measures are not taken. The fluid preloading or coloading, left lateral uterine displacement and prophylactic vasopressors have shown to be effective in preventing postspinal hypotension.

153 The effects of parity and oxytocin or prostaglandin F2α added to insemination doses on reproductive performance of pigs bred in summer

2020 ◽  
Vol 32 (2) ◽  
pp. 203
Author(s):  
T. Schwarz ◽  
P. Jaros ◽  
R. Tuz ◽  
J. Nowicki ◽  
P. M. Bartlewski
Keyword(s):  
Reproductive Performance ◽  
Prostaglandin F2α ◽  
Numerical Data ◽  
Chi Square ◽  
Mean Values ◽  
Young Females ◽  
Significant Difference ◽  
Boar Semen ◽  
The Mean ◽  
Semen Extender

Summer is the least favourable season for swine reproduction, mainly due to long photoperiods and heat stress. Such conditions negatively impinge on the reproductive system of sows and boars, manifesting in debilitated uterine and gonadal function. This situation is exacerbated by the dilution of ejaculates in semen extender before AI. Consequently, there is a noticeable decline in piglet productivity of summer-breeding gilts and sows. The main goal of this study was to determine the effect of oxytocin (OX) or prostaglandin F2α analogue (PG) added to boar semen extender on the duration of insemination and reproductive performance of pigs bred in July and August. A total of 144 females (80 gilts and second-parity sows (G+SP) and 64 multiparous sows (M)) were divided into three groups (n=48 per group). The OX (11 G+SP and 37M) and PG (20 G+SP and 28M) groups were inseminated twice (at the onset of behavioural oestrus and 22-24h later) using semen supplemented with 20IU of OX or 5mg of PG, respectively; the controls (33 G+SP and 15M) were artificially inseminated with non-supplemented inseminate doses. Pregnancy was detected ultrasonographically on gestational day 42, and the number and viability of piglets were recorded at farrowing. Proportions were analysed using chi-square test (Brandt and Snedecor formula), and other numerical data were analysed using two-way analysis of variance and least significant difference test to determine the differences between individual mean values (SigmaPlot, Systat Software Inc.). The mean duration of first insemination was shorter (P&lt;0.05) in M females (80±22s) compared with G+SP females (191±26s) inseminated with PG-supplemented semen, whereas the second insemination was shorter (P&lt;0.05) in M females than in G+SP females artificially inseminated with OX-supplemented semen (93±15s compared with 192±28s). The mean pregnancy rate was lower (P&lt;0.05) in control G+SP females (26/33; 85%) than in OX G+SP females (11/11; 100%). The farrowing rate was less (P&lt;0.05) in control females (36/48; 75%) than in OX females (44/48; 92%), and it was less (P&lt;0.05) in PG G+SP females (14/20; 70%) compared with PG M females (26/28; 93%). The M females in the OX group had more (P&lt;0.05) stillborn piglets per litter compared with their G+SP counterparts (0.6±0.1 vs. 0.1±0.1). Overall, PG females had more (P&lt;0.05) weak piglets per litter (1.2±0.2) compared with the control (0.5±0.2) and OX (0.6±0.2) groups. The present results reveal the occurrence of both beneficial and undesirable effects of PG and OX added to boar semen extender on reproductive performance of breeding pigs in summer. Addition of PG was associated with shorter first-insemination times in older sows compared with G+SP animals but also with lower farrowing rates in younger animals and an overall increase in the number of weak piglets at farrowing. Supplementation of OX was in turn associated with a shorter second insemination and higher pregnancy rates in young females but more stillborn piglets per litter in multiparous sows. The specific causative mechanisms of these associations remain to be elucidated.

scholarly journals Satisfação com os Cuidados Anestésicos num Hospital Central

2014 ◽  
Vol 27 (1) ◽  
pp. 33 ◽  
Author(s):  
Ana Catarina Moura ◽  
Maria Amélia Ferreira ◽  
Joselina Barbosa ◽  
Joana Mourão
Keyword(s):  
Elective Surgery ◽  
Quality Criteria ◽  
Three Dimensions ◽  
Mean Values ◽  
Global Satisfaction ◽  
Assess Patient Satisfaction ◽  
High Satisfaction ◽  
The Mean ◽  
Psychometric Quality

<strong>Introduction:</strong> The satisfaction level with health care reflects the quality of care from the patient’s perspective. The aim of this study is to assess patient satisfaction with anesthesia care in a Portuguese general hospital by using the “The Heidelberg Peri-anaesthetic Questionnaire”.<br /><strong>Material and Methods:</strong> The questionnaire was translated and tested based on psychometric quality criteria in a sample of 107 patients who underwent elective surgery as inpatients at Hospital de São João. The global satisfaction and for each dimension of care were calculated. We analyzed the differences between patients with different levels of satisfaction, identifying potential confounding factors.<br /><strong>Results:</strong> The Portuguese version of the questionnaire has 32 items distributed in three dimensions: ‘staff’, ‘discomfort’ and ‘fear’. The mean values of satisfaction for each dimension were 83.4%, 66.8% and 65.9%, respectively. The internal consistence was demonstrated by a Cronbach’s alpha coefficient ranging from 0.776 to 0.875 in the three dimensions. Satisfied and dissatisfied patients differed in the three dimensions, but to a lesser degree in ‘staff’. In the multivariate analysis we found significant influence of gender in the ‘discomfort’ dimension.<br /><strong>Discussion: </strong>The questionnaire has good psychometric characteristics. The domain ‘staff’ includes three domains of the source questionnaire.<br /><strong>Conclusions:</strong> Its application revealed high satisfaction levels regarding the staff. Dissatisfaction was mainly seen in the “fear” and “discomfort” dimensions, the latter being significantly lower in males.

scholarly journals PREVENTION OF SHIVERING DURING LOWER SEGMENT CESAREAN SECTION;

2013 ◽  
Vol 20 (03) ◽  
pp. 409-415
Author(s):  
ASHFAQ AHMED ◽  
MOHAMMAD ASLAM
Keyword(s):  
Cesarean Section ◽  
Spinal Anesthesia ◽  
Carbon Dioxide Production ◽  
Double Blind Study ◽  
Lower Segment ◽  
Chi Square ◽  
Double Blind ◽  
Lower Segment Cesarean Section ◽  
Group I ◽  
Group Ii

Objectives: To compare the efficacy of low-dose prophylactic use of ketamine with ketamine plus midazolam for theprevention of shivering caused by spinal anesthesia, during lower segment cesarean section. Main Outcome Measures: Heamodynamicmonitoring, avoidance of lactic acidosis/ increased carbon dioxide production and patient satisfaction. Design: Prospective RandomizedControlled trial. Place: Department of Anesthesia and ICU PNS Shifa Karachi. Duration of study: March 2010 to June 2010. Patients andMethods: 100 ASA-I & II consecutive patients who reported for LSCS in PNS Shifa Hospital were studied. In this double-blind study,patients were randomly allocated to receive ketamine alone (Group I, n= 50), and ketamine plus midazolam (Group II, n = 50). Afterstandardized Spinal anesthesia, a shivering was recorded at 5 min intervals for 15 minutes. Results: Shivering was observed in 9/50(18%) patients of group I (Ketamine only) as compared to only 2/50 (4%) patients in Group II (ketamine + midazolam) (p=0.025) whichis statically significant. The two groups were comparable regarding distribution of age (p=0.37), BMI (p=0.27) and duration of surgery.Results were analyzed by using chi square test. Conclusions: The efficacy of i.v. ketamine plus midazolam is better as compared to lowdosei.v. ketamine alone in preventing shivering in lower segment Cesarean Section patients, during spinal anesthesia.

scholarly journals Effect of Spinal Anesthesia versus General Anesthesia on Blood Glucose Concentration in Patients Undergoing Elective Cesarean Section Surgery: A Prospective Comparative Study

2019 ◽  
Vol 2019 ◽  
pp. 1-6
Author(s):  
Khaled El-Radaideh ◽  
Ala’’a Alhowary ◽  
Mohammad Alsawalmeh ◽  
Ahmed Abokmael ◽  
Haitham Odat ◽  
...  
Keyword(s):  
Blood Glucose ◽  
Cesarean Section ◽  
General Anesthesia ◽  
Spinal Anesthesia ◽  
Glucose Concentration ◽  
Blood Glucose Concentration ◽  
Elective Cesarean Section ◽  
Elective Cesarean ◽  
Prospective Comparative Study ◽  
The Mean

Background. This prospective study compared the blood glucose concentration with spinal anesthesia or general anesthesia in patients undergoing elective cesarean section surgery. Methods. In total, 58 pregnant women who underwent elective cesarean section surgery were included in this prospective comparative study. Group S (n = 35) included patients who chose spinal anesthesia, and group G (n = 23) included patients who chose general anesthesia. The patients were allocated to the groups upon patients’ preference. For the group G, the blood glucose concentration (BGC) was obtained 5 minutes before induction, T1, and 5 minutes after induction T2. For the group S, the BGC was obtained immediately before the injection of the local anesthetic agent T1 and 5 minutes after the complete block T2. For both groups, BGC was measured 5 minutes before the end of surgery T3 and 30 minutes after the end of surgery T4. For BGC measurements, we used a blood glucose monitoring system with a lancet device to prick the finger. Results. There was no statistically significant difference in the mean blood glucose concentration between the groups S and G in T1 (78.3 ± 18.2 vs. 74.3 ± 14.7, p>0.05) and T2 (79.2 ± 18.3 vs. 84.9 ± 23.7, p>0.05). The mean BGC was statistically significantly higher in group G in comparison to group S in the times 5 minutes before (80.2 ± 18.1 vs. 108.4 ± 16.7, p<0.05) and 30 minutes after the end of surgery (80.9 ± 17.7 vs. 121.1 ± 17.4, p<0.05). Conclusion. There is a much lower increase in blood glucose concentration under spinal anesthesia than under general anesthesia. It is reasonable to suggest that the blood sugar concentration must be intraoperatively monitored in patients undergoing general anesthesia.

scholarly journals The Prophylactic Administration of Intravenous Paracetamol for Control of Shivering During and After Cesarean Section Under Spinal Anesthesia

2019 ◽  
Author(s):  
Sousan Rasoli ◽  
Elnaz Ansari ◽  
Farnaz Moslemi ◽  
Morteza Ghojazadeh
Keyword(s):  
Cesarean Section ◽  
Spinal Anesthesia ◽  
Operating Room ◽  
Recovery Room ◽  
Control Group ◽  
Double Blind ◽  
Prophylactic Administration ◽  
Intravenous Paracetamol ◽  
Rate Of Increase ◽  
The Mean

Background: Shivering refers to a series of repetitive involuntary movements of the skeletal muscles commonly occurring during spinal anesthesia. Regional anesthesia (both spinal and Epidural) reduces vasoconstriction and shivering threshold to 6 degrees Celsius above the surface of the block. The aim of this study was to determine the effect of prophylactic administration of intravenous paracetamol in controlling shivering during and after cesarean section under spinal anesthesia. Methods: In a double-blind randomized clinical trial in the Department of Anesthesiology of Tabriz on patients undergoing cesarean section with spinal anesthesia, the effect of prophylactic administration of paracetamol IV in controlling shivering during and after cesarean section under spinal anesthesia was evaluated. Results: The mean gestational age of patients was 37.94±1.07 weeks in paracetamol group and 37.58±2.07 weeks in the control group (p=0.278). The mean shivering scores of patients in paracetamol group were 0.72±0.80 in the operating room and 1.32±1.05 in recovery room (P<0.001). The mean shivering scores of patients in control group were 1.16±1.07 in the operating room and 2.28±1.45 in recovery room (P<0.001). The mean increase of shivering score in patients was 0.60±0.98 in paracetamol group and 1.12±1.46 in the control group. The mean increase of shivering score in patients in paracetamol group was significantly less than the control group (p=0.041). Conclusion: In the present study, the prophylactic use of intravenous acetaminophen reduced the rate of increase of shivering in patients after spinal anesthesia. Postoperative complications in patients in paracetamol group was less than the control group, however, this difference was not statistically significant.

scholarly journals The effect of conventional versus electronic cigarette use on treatment outcomes of peri-implant disease

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Reham AlJasser ◽  
Mohammed Zahid ◽  
Mohammed AlSarhan ◽  
Dalal AlOtaibi ◽  
Saleh AlOraini
Keyword(s):  
Study Groups ◽  
Post Treatment ◽  
Electronic Cigarette ◽  
Risk Indicator ◽  
Chi Square ◽  
Cigarette Smokers ◽  
Mean Values ◽  
The Mean ◽  
Significant Change ◽  
One Year

Abstract Aim To compare changes in clinical periodontal parameters (gingival consistency, colour, BOP, PI, PD) and changes of salivary inflammatory biomarkers (IL-1 β, IL-6, MMP-8, TNF- α and TIMP-1 between conventional, electronic cigarette smokers and non-smokers after peri-implant treatment. Methods Study participants were grouped into three groups (i) Conventional cigarette smokers (ii) Electronic cigarette smokers and (iii) non-smokers respectively. A total of 60 adult patients aged (40–56 years) with 60 implants with active per-impantitis was included.Clinical and Biological parameters were evaluated before surgical treatment at baseline, one, six and twelve month post treatment. Pearson’s chi-square test was used to compare the distribution of the categorical while Two-way repeated analysis of variance was used to compare the mean values of quantitative outcome variables among all study groups across the 4 time points. Results A total of 60 subjects (60 implants) were selected and classified into three groups as per their smoking method 20 participants in each group with one single targeted implant diagnosis with active peri-implantitis. The gingival colour, the change was statistically significant at one year of post treatment.The gingival consistency distribution across the three groups is not statistically significant at baseline, but it is statistically significant at one-month (p = 0.001), six months (p = 0.029) and at the completion of one-year (p = 0.018) post treatment. The plaque index of 100% of non-smokers had changed to ‘0’ and 35% change in cigarettes and 30% change in electronic smokers which is statistically significant (p = 0.016).The prevalence of BOP was observed in the three groups as 72%, 76.5% and 88.9% at baseline. The mean values of PD have shown statistically significant change across the three groups over the four-time intervals of observation (p = 0.024). The comparison of mean values of IL-1 β, IL-6 and TIMP-1 has shown statistically significant change across the three groups over the four intervals of observation (p < 0.0001). Conclusions Electronic cigarette smoking was found to be most prevalent risk indicator for peri-implantitis. Compromised response of peri-implantitis treatment both clinically and biologically was found more among electronic cigarette smokers when compared to conventional cigarette smokers and non-smokers. Trial registration: This case-control study was conducted at King Saud University’s Dental College, Riyadh, Saudi Arabia, in accordance with “Helsinki Declaration of Human Studies” and approved by the Institutional Review Board (Reference no: 87563).

scholarly journals A Clinical Trial on the Effects of Different Regimens of Phenylephrine on Maternal Hemodynamic After Spinal Anesthesia for Cesarean Section

2020 ◽  
Vol 10 (4) ◽  
Author(s):  
Mahshid Nikooseresht ◽  
Mohammad Ali Seifrabiei ◽  
Pouran Hajian ◽  
Shadab Khamooshi
Keyword(s):  
Blood Pressure ◽  
Clinical Trial ◽  
Cesarean Section ◽  
Spinal Anesthesia ◽  
Cesarean Delivery ◽  
Saline Control ◽  
Control Group ◽  
Significant Difference ◽  
The Mean ◽  
Phenylephrine Infusion

Background: Phenylephrine is used to prevent and treat hypotension during spinal anesthesia for cesarean delivery. Objectives: The present study aims to investigate the effects of different regimens of phenylephrine on blood pressure of candidates for the cesarean section. Methods: In this double-blind, randomized clinical trial, a total of 120 candidates of elective cesarean delivery under spinal anesthesia was randomly categorized into three groups. Groups 1, 2, and 3 received bolus and prophylactic saline (control group), prophylactic bolus phenylephrine (100 µg), and prophylactic phenylephrine infusion (50 µg/min), respectively. The incidence of hypotension, maternal hemodynamics, hypertension, rescue phenylephrine dose, nausea, and vomit were compared between the groups. Results: In all the three groups, the incidence of nausea and vomit, bradycardia, hypertension, and neonatal Apgar score were not statistically different (P > 0.05). However, the adjuvant phenylephrine dose requirement was remarkably different. Moreover, the mean systolic blood pressure differed significantly in the second and 7th minutes after the spinal block (P < 0.05). 35% in the first group, 15% in the second group, and 2.5% in the third group had hypotension (P = 0.001). Apart from the first measurement after spinal anesthesia, the mean heart rate showed no significant difference between the groups. Conclusions: The use of prophylactic phenylephrine infusion is recommended to control the optimal blood pressure in parturients undergoing cesarean section after spinal anesthesia.

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