scholarly journals Comparison of Phenylephrine and Ephedrine in the Treatment of Hypotension and Its Effects on the Foetus after Subarachnoid Block for Caesarean Section

2021 ◽  
Vol 10 (44) ◽  
pp. 3775-3780
Author(s):  
Khawer Muneer ◽  
Hina Khurshid ◽  
Venkatesh H. K.
Keyword(s):  
Blood Pressure ◽  
Caesarean Section ◽  
Systolic Blood Pressure ◽  
Base Excess ◽  
P Value ◽  
Acid Base ◽  
Apgar Scores ◽  
Subarachnoid Block ◽  
Significant Difference ◽  
Acid Base Status

BACKGROUND Subarachnoid block has been widely used for caesarean sections and is found to be safe. Hypotension being the most common complication may adversely affect both the mother and foetus. Different measures used to treat this hypotension include preloading with crystalloids/colloids and treatment with vasopressors. The standard choice of vasopressor agents such as ephedrine and phenylephrine is still a controversial issue. It is therefore important to compare the efficacy of the two drugs in the prevention and treatment of maternal hypotension after subarachnoid block and particularly assess their effect on the foetus. The purpose of this study was to assess and compare the foetal acid-base status and APGAR score following administration of bolus dose of ephedrine or phenylephrine that was given intravenously for maintenance of arterial blood pressure during lower segment caesarean section (LSCS) under a subarachnoid block. METHODS 100 parturients (18 to 35 years) scheduled for elective caesarean section under subarachnoid block were selected and divided into two groups of 50 each. Group P received 50 mcg i.v bolus of phenylephrine and Group E received 6 mg of ephedrine IV bolus whenever the blood pressure dropped 20 % from baseline or systolic blood pressure ˂ 90 mmHg. Haemodynamic parameters were measured in all patients. APGAR scores at 1 and 5 minutes following delivery of baby were assessed and cord blood was obtained for acid-base status analysis immediately following delivery. RESULTS Hemodynamic parameters including heart rate, systolic blood pressure, diastolic blood pressure, and mean arterial pressure did not show any significant difference between the two groups, however, Group E showed higher heart rates. The difference in umbilical artery pH (P-value < 0.001) and base excess (P-value = 0.004) was statistically significant with Group E showing lower pH and higher base excess values than Group P. There was no statistically significant difference in neonatal APGAR scores between the two groups. CONCLUSIONS Phenylephrine and ephedrine are equally efficient in managing hypotension during subarachnoid block for caesarean delivery. Thus, either vasopressor can be used although phenylephrine may be a better choice. KEY WORDS Caesarean Section, Phenylephrine, Ephedrine.

scholarly journals COMPARISON OF HAEMODYNAMIC STABILITY WITH 0.5% AND 0.75% HYPERBARIC BUPIVACAINE DURING SPINAL ANAESTHESIA IN WOMEN UNDERGOING CAESAREAN SECTION

2021 ◽  
Vol 71 (6) ◽  
pp. 2078-81
Author(s):  
Hina Iftikhar ◽  
Aneel Aslam ◽  
Habib Ur Rehman ◽  
Zulfiqar Ali ◽  
Mohammad Ali Abbass ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Caesarean Section ◽  
Systolic Blood Pressure ◽  
Spinal Anaesthesia ◽  
P Value ◽  
Hyperbaric Bupivacaine ◽  
Haemodynamic Stability ◽  
The Mean ◽  
The Difference

Objective: To compare the effect of 0.5% and 0.75% hyperbaric Bupivacaine on haemodynamic stability in terms of mean systolic blood pressure and heart rate recorded at 4 min in patients undergoing caesarian section in spinal anesthesia. Study Design: Quasi experimental study. Place and Duration of Study: Department of Anaesthesiology, Combined Military Hospital, Malir, from Jul to Dec 2018. Methodology: The patients were assigned in two groups (A and B) using lottery method. Group A received 0.5% hyperbaric Bupivacaine solution. Group B received 0.5% hyperbaric Bupivacaine solution. Spinal anaesthesia was given, blood pressure and heart rate were recorded. Data were analyzed in SPSS version 23. Both groups were compared for mean systolic blood pressure and heart rate by using independent sample t-test. Results: The mean age of patients was 29.62 ± 6.21 years in 0.75% Bupivacaine group while 29.31 ± 6.20 years in 0.5% Bupivacaine group. The mean systolic blood pressure of patients was 111.63 ± 5.96 mmHg in 0.75% Bupivacaine group while 117.16 ± 7.12 mmHg in 0.5% Bupivacaine group. The difference was significant in both groups (p-value <0.05). The mean heart rate of patients was 92.27 ± 4.71 beats per min (bpm) in 0.75% Bupivacaine group while 97.68 ± 4.58 bpm in 0.5% Bupivacaine group. The difference was significant in both groups (p-value <0.05). Conclusion: 0.5% hyperbaric Bupivacaine was better than 0.75% hyperbaric Bupivacaine solution in spinal anaesthesia during caesarean section.

Left Lateral Table Tilt for Elective Cesarean Delivery under Spinal Anesthesia Has No Effect on Neonatal Acid–Base Status

2017 ◽  
Vol 127 (2) ◽  
pp. 241-249 ◽  
Author(s):  
Allison J. Lee ◽  
Ruth Landau ◽  
James L. Mattingly ◽  
Margaret M. Meenan ◽  
Beatriz Corradini ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Spinal Anesthesia ◽  
Cesarean Delivery ◽  
Umbilical Artery ◽  
Base Excess ◽  
Elective Cesarean Delivery ◽  
Acid Base ◽  
Elective Cesarean ◽  
Acid Base Status ◽  
Phenylephrine Infusion

Abstract Background Current recommendations for women undergoing cesarean delivery include 15° left tilt for uterine displacement to prevent aortocaval compression, although this degree of tilt is practically never achieved. We hypothesized that under contemporary clinical practice, including a crystalloid coload and phenylephrine infusion targeted at maintaining baseline systolic blood pressure, there would be no effect of maternal position on neonatal acid base status in women undergoing elective cesarean delivery with spinal anesthesia. Methods Healthy women undergoing elective cesarean delivery were randomized (nonblinded) to supine horizontal (supine, n = 50) or 15° left tilt of the surgical table (tilt, n = 50) after spinal anesthesia (hyperbaric bupivacaine 12 mg, fentanyl 15 μg, preservative-free morphine 150 μg). Lactated Ringer’s 10 ml/kg and a phenylephrine infusion titrated to 100% baseline systolic blood pressure were initiated with intrathecal injection. The primary outcome was umbilical artery base excess. Results There were no differences in umbilical artery base excess or pH between groups. The mean umbilical artery base excess (± SD) was −0.5 mM (± 1.6) in the supine group (n = 50) versus −0.6 mM (± 1.5) in the tilt group (n = 47) (P = 0.64). During 15 min after spinal anesthesia, mean phenylephrine requirement was greater (P = 0.002), and mean cardiac output was lower (P = 0.014) in the supine group. Conclusions Maternal supine position during elective cesarean delivery with spinal anesthesia in healthy term women does not impair neonatal acid–base status compared to 15° left tilt, when maternal systolic blood pressure is maintained with a coload and phenylephrine infusion. These findings may not be generalized to emergency situations or nonreassuring fetal status.

scholarly journals EFFECT OF PRENATAL YOGA ON ANXIETY, BLOOD PRESSURE, AND FETAL HEART RATE IN PRIMIGRAVIDA MOTHERS

2017 ◽  
Vol 3 (3) ◽  
pp. 246-254 ◽  
Author(s):  
Hamdiah Hamdiah ◽  
Ari Suwondo ◽  
Triana Sri Hardjanti ◽  
Ariawan Soejoenoes ◽  
M Choiroel Anwar
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Systolic Blood Pressure ◽  
Fetal Heart Rate ◽  
Rating Scale ◽  
Fetal Heart ◽  
Alternative Therapy ◽  
Control Group ◽  
P Value ◽  
Significant Difference

Background: Pregnancy increases the risk of developing anxiety that may affect the fetus. Yoga is considered as an alternative therapy to reduce anxiety, blood pressure, and fetal heart rate.Objective: This study aimed to examine the effect of prenatal yoga on anxiety, blood pressure, and fetal heart rate in primigravida mothers.Methods: There were 39 primigravida mothers selected using purposive sampling, which divided to be an experiment group with four-times prenatal yoga and eight-times prenatal yoga, and a control group. The Hamilton Rating Scale For Anxiety (HRSA) was used. Data were analyzed using One way ANOVA and MANOVA.Results: There was a statistically significant difference of prenatal yoga on anxiety (P=0.005), systolic blood pressure (P=0.045), and fetal heart rate (P=0.010). However, there was no significant difference of prenatal yoga on diastolic blood pressure with p-value 0.586 (>0.05)Conclusion: There were significant effects of prenatal yoga on anxiety level, systolic blood pressure, and the fetal heart rates in primigravida mothers. The findings of this study can be an alternative treatment for midwife to deal with anxiety during pregnancy, and an input on the class program of pregnant women to improve the quality of maternal and fetal health.

scholarly journals Hypertension Exercise Videos Reduce Blood Pressure of Hypertension Patients

2021 ◽  
Vol 9 (T4) ◽  
pp. 296-299
Author(s):  
Harmilah Harmilah ◽  
Bondan Palestin ◽  
Ana Ratnawati ◽  
Agus Sarwo Prayogi ◽  
Catur Budi Susilo
Keyword(s):  
Blood Pressure ◽  
Systolic Blood Pressure ◽  
Sampling Technique ◽  
The Elderly ◽  
Reduce Blood Pressure ◽  
Control Group ◽  
P Value ◽  
Significant Difference ◽  
Quasi Experimental ◽  
The Mean

BACKGROUND: Hypertension is a symptom of a cardiovascular degenerative disease that is mostly experienced by the elderly and cause is not certain. However, the reduction of blood pressure with drugs and non drugs can reduce damage to target organs and prevent cardiovascular diseases. AIM: Identified the effect of hypertension exercise videos of lowering blood pressure. METHODS:  The type of research that has been used is quasi experimental with Pretest and Posttest design with control group. The sampling technique used was random sampling, the number of samples was 30 samples which were the treatment group and 30 samples were control the control group. The data analysis used  was the T test and Wilcoxon and Mann Whitney test. RESULTS:  The mean reduction in systolic blood  pressure in respondents who did exercise  was 13.67 mm Hg with a standard deviation of 10.57, while the mean  in systolic  blood  pressure in respondents who did not exercise was 0.50 mmHg  a pressure were 40.95 in the group of respondents who did hypertension exercise with p value =0.000.This mean that there is significant difference, in the mean reduction in systolic and diastolic blood pressure between respondents those who do exercise. CONCLUSION. Hypertension exercise video reduce blood pressure of hypertension patients.

scholarly journals PENURUNAN TEKANAN DARAH MELALUI SENAM BUGAR LANSIA PADA LANSIA DENGAN HIPERTENSI

2021 ◽  
Vol 12 (1) ◽  
Author(s):  
Irma Mustika Sari
Keyword(s):  
Blood Pressure ◽  
Physical Exercise ◽  
Systolic Blood Pressure ◽  
Diastolic Blood Pressure ◽  
Heart Function ◽  
Research Result ◽  
The Elderly ◽  
P Value ◽  
Significant Difference ◽  
Post Test

ABSTRAKLatar Belakang : Hipertensi banyak menyebabkan morbiditas pada setiap orang khususnya kepada lansia. Penanganan hipertensi dapat dilakukan dengan memperbaiki pola hidup serta dengan terapi non farmakologis yaitu dengan melakukan latihan fisik. Latihan fisik atau senam dapat membantu kekuatan pompa jantung agar bertambah, sehingga aliran darah bisa kembali lancar sehingga dapat meningkatkan faal jantung dan menurunkan tekanan darah. Adanya peningkatan tekanan darah pada lansia di Posyandu Lansia Pucangsawit sebanyak 44 orang yang belum pernah melakukan aktifitas fisik atau senam. Tujuan Penelitian : Menganalisis pengaruh senam bugar lansia terhadap tekanan darah pada penderita hipertensi. Metode Penelitian : Quasy eksperimental study dengan one group pretest-posttest design. Hasil Penelitian ; Hasil analisis menunjukkan tekanan darah sistolik pre test dan post test pada tabel didapatkan nilai p value 0,000 (p < 0,05), sedangkan dari hasil analisis pengukuran tekanan darah diastolik pre test dan post test didapatkan nilai p value 0,059 (p > 0,05). Simpulan : Ada perbedaan yang signifikan antara nilai tekanan darah sistolik pre test dan post test setelah dilakukan senam bugar lansia. Tidak ada perbedaan yang signifikan nilai tekanan darah diastolik pre test dan post test setelah dilakukan senam bugar lansia. Kata kunci : Senam bugar, lansia, hipertensi, tekanan darahABSTRACT REDUCTION OF BLOOD PRESSURE THROUGH ELDERLY FIT EXERCISES AMONG WITH HYPERTENSION Background: Hypertension causes a lot of morbidity in everyone, especially the elderly. handling of hypertension can be done by improving lifestyle and non-pharmacological therapy, namely by doing physical exercise. physical exercise or gymnastics can help increase the strength of the heart's pump, so that blood flow can return smoothly so that it can increase heart function and lower blood pressure. there was an increase in blood pressure in the elderly at Posyandu Lansia Pucangsawit as many as 44 people who had never done physical activity or gymnastics. Objective: To analyze the effect of exercise fitness on the elderly on blood pressure in patients with hypertension. Research Methods: Quasy experimental study with one group pretest-posttest design. Research result ; The analysis showed that the systolic blood pressure pre test and post test in the table obtained p value 0,000 (p <0.05), while the results of the analysis of diastolic blood pressure measurements pre test and post test obtained p value of 0.059 (p> 0.05). Conclusion: There is a significant difference between the systolic blood pressure values of the pre-test and post-test after doing fitness exercises for the elderly. There were no significant differences in the values of diastolic blood pressure pre-test and post-test after doing fitness exercises for the elderly.Keywords : Fit Exercise, elderly, hypertension, blood pressure

scholarly journals Differences in The Measurement of The Right And Left Form of Blood Pressure in Hypertension Patients

2020 ◽  
Vol 2 (3) ◽  
pp. 105
Author(s):  
Anang Nurmoko ◽  
Ana Fadilah ◽  
Eny Pujiati
Keyword(s):  
Blood Pressure ◽  
Systolic Blood Pressure ◽  
P Value ◽  
Hypertensive Patients ◽  
Average Systolic Blood Pressure ◽  
Adult Age ◽  
Hypertension Patient ◽  
Significant Difference ◽  
The Difference ◽  
The Right

Hypertension is one of the number one causes of death, globally. Hypertension is the most common cause of cardiovascular events and is a major problem in both developed and developing countries. Cardiovascular is also the number one cause of death in the world every year. Respondents in this study were patients with a diagnosis of hypertension in hospitalized patients at Mardi Rahayu Kudus Hospital, totalling 41 people. the characteristics of hypertension patient respondents seen from the age of the most patients are in the late adult age category (36-45 years), namely 31 people (75.6%), while for early adulthood (26-45 years). 35 years) as many as 10 people (24.4%). The characteristics of hypertension patient respondents seen from the sex of the most patients were male, namely 25 people (61.0%), while the female gender was 16 people (39.0%). Results The highest systolic blood pressure was 170 mmHg and the lowest was 145 mmHg. The average systolic blood pressure was 152.90 mmHg. In hypertensive patients on the left arm, the highest systolic blood pressure was 170 mmHg and the lowest was 145 mmHg. The average systolic blood pressure was 152.90 mmHg. Based on the dependent t-test, the t value is -12.491 with a p-value of 0.000. It can be seen that the p-value is 0.000 < (0.05), this indicates that there is a significant difference in the results of blood pressure measurements between the right arm and the left arm in hypertensive patients in the inpatient room of Mardi Rahayu Kudus Hospital. The difference in blood pressure variations obtained in this study is still considered normal because the difference in MAP between the right and left arms is 6.11 mmHg (normal 10-20 mmHg).

scholarly journals Effectiveness of Intravenous Ephedrine Infusion during Spinal Anaesthesia for Caesarean Section Based on Maternal Hypotension, Neonatal Acid-base Status and Lactate Levels

2002 ◽  
Vol 30 (3) ◽  
pp. 316-320 ◽  
Author(s):  
A. Turkoz ◽  
T. Togal ◽  
R. Gokdeniz ◽  
H. I. Toprak ◽  
O. Ersoy
Keyword(s):  
Blood Pressure ◽  
Caesarean Section ◽  
Spinal Anaesthesia ◽  
Nausea And Vomiting ◽  
Bolus Administration ◽  
Acid Base ◽  
Infusion Group ◽  
Umbilical Blood ◽  
Acid Base Status ◽  
Lactate Levels

Maternal cardiovascular changes and neonatal acid-base status, including lactate levels, were assessed in 30 healthy women undergoing elective caesarean section under spinal anaesthesia. Patients were allocated randomly to receive IV ephedrine infusion (n=15) (5 mg.min -1 ) immediately after the spinal injection or bolus administration of IV ephedrine (n=15) (10 mg) in case of development of hypotension. Maternal and neonatal blood pressure, heart rate and acid-base status including lactate levels were compared between the groups. Systolic blood pressure in the bolus group was significantly lower when compared to the infusion group. Nausea was observed in one patient (6%) in the infusion group and nausea and vomiting were observed in 10 patients (66%) in the bolus group. Although umbilical arterial pH values were significantly lower in the bolus group, lactate levels were similar. In conclusion, ephedrine infusion prevented maternal hypotension, reduced the incidence of nausea and vomiting and led to improved umbilical blood pH during spinal anaesthesia for caesarean section.

scholarly journals A comparative evaluation of post placental intrauterine contraceptive device (IUCD) insertion between normal delivery and caesarean section

2018 ◽  
Vol 7 (9) ◽  
pp. 3826
Author(s):  
Sharmistha Sarkar ◽  
Dhruba Prasad Paul ◽  
Jayanta Ray
Keyword(s):  
Caesarean Section ◽  
Vaginal Delivery ◽  
Comparative Evaluation ◽  
P Value ◽  
Contraceptive Device ◽  
Government Medical College ◽  
Expulsion Rate ◽  
Medical College ◽  
Significant Difference ◽  
Post Placental

Background: Adverse maternal and perinatal outcomes are related to pregnancies spaced too closely together. Objective of present study was to compare the expulsion rate and complications between post placental IUCD insertion between caesarean section and vaginal delivery.Methods: This study was a prospective comparative study conducted in the department of Obstetrics and Gynecology, at Agartala Government Medical College over 1.5 Years (January 2016-June2017) All cases at term pregnancy delivering by caesarean section and vaginal delivery were divided into two different groups. Sample size of 105 in each group. Subjects recruited from-obstetrics OPD and casualty of Agartala Government Medical College (AGMC) and GB Pant Hospital expulsion rate and complications. Comparative evaluation of Expulsion rate and complications following post placental IUCD insertion between caesarean section and vaginal delivery at the end of six months, one year and one and half year.Results: There was no significant difference in either complications between the two groups (P value-.913) or outcomes (p value-.035). Expulsion rate 18.2% following vaginal delivery compared to those with intracaesarean insertion i.e 3.8%.Conclusions: The complications associated with postplacental Intrauterine device insertion is insignificant, still the awareness, acceptance and continuation are very low. Therefore Information, education Communication activity by the field workers must be enhanced to overcome this knowledge gap.

Depressed Apgar Scores, Acid-Base Status, and Neurologic Outcome

1995 ◽  
Vol 39 (3) ◽  
pp. 150
Author(s):  
M. L. SOCOL ◽  
P. M. GARCIA ◽  
S. RITER
Keyword(s):  
Neurologic Outcome ◽  
Acid Base ◽  
Apgar Scores ◽  
Acid Base Status

Reduction Blood Pressureby Neck Massage Therapy Using Virgin Coconut Oil (VCO) and Dry Cupping Therapy

2021 ◽  
Vol 8 (1) ◽  
pp. 019-025
Author(s):  
Nurul Faidah ◽  
Ni Kadek Muliawati
Keyword(s):  
Blood Pressure ◽  
Systolic Blood Pressure ◽  
Diastolic Blood Pressure ◽  
Communicable Disease ◽  
Massage Therapy ◽  
Sampling Technique ◽  
Complementary Therapy ◽  
Cupping Therapy ◽  
Pharmacological Therapy ◽  
P Value

Hypertension is a non-communicable disease which increases every year, with the increasing incidence of Hypertension will have an impact on society, namely a decrease in health status which results in a decrease in the quality of life. Management of hypertension can be done with non-pharmacological therapy, one of the non-pharmacological therapies chosen by the community, namely complementary therapy, neck massage therapy using VCO and cupping is a complementary therapy that aims to reduce hypertension. The sampling technique used was purposive sampling. The sample in this study 16 respondents were given neck massage therapy with VCO and 16 respondents were given dry cupping therapy. The data analysis used was the Spearman rank because the data were not normally distributed. Before being given neck massage therapy with a mean VCO, systolic blood pressure was 156.25, diastolic blood pressure was 87.50 after being given a mean value of 124.38 and diastolic 81.25 with a systolic p value of 0.000 while for diastolic blood pressure of 0.008. Whereas in the group given dry cupping therapy systolic blood pressure with a mean of 158.82 and diastole a mean of 90.59, after being given dry cupping therapy, systolic blood pressure was 124.71 while diastole was 78.82 with a systolic p value of 0.000 and diastole of 0.009. The difference in blood pressure in the two interventions for the system p value was 0.968 while for diastole the p value was 0.625, which means there was no difference between the two interventions. So it can be concluded that both neck massage therapy with VCO and dry cupping therapy can reduce blood pressure in patients with hypertension.

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