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BACKGROUND We want to compare intravenous bolus of Phenylephrine and Ephedrine in treating the spinal hypotension in lower segment caeserian section MATRIALS & METHODS It was an institution-based cross-sectional, observational study conducted in Patients who are undergoing Lower Segment Cesarean Section admitted in the department of Obstetrics &Gynaecology at a tertiary care hospital who satisfy inclusion criteria and who give informed written informed consent during the period of May 2022 to May 2024. RESULTS The study demonstrates that phenylephrine and ephedrine have distinct effects on hemodynamic parameters during cesarean sections under spinal anesthesia. Phenylephrine maintains higher SBP and MAP at specific intraoperative time points, while ephedrine provides better DBP stability and induces higher pulse rates intraoperatively. Both drugs contribute to overall hemodynamic stability, with their differential effects reflecting their distinct pharmacological actions and implications for managing spinal-induced hypotension in clinical practice. Systolic Blood Pressure (SBP): Phenylephrine demonstrated higher mean SBP compared to ephedrine at specific intraoperative time points, notably at 5 minutes and 20 minutes intraoperatively. These differences were statistically significant, indicating that phenylephrine effectively maintained higher SBP during these critical periods. However, at other time intervals, there was no significant difference in SBP between the phenylephrine and ephedrine groups, suggesting variable trends but a consistent tendency towards higher SBP with phenylephrine. Diastolic Blood Pressure (DBP): Ephedrine exhibited higher mean values of DBP at 1 minute, 5 minutes intraoperatively, and 30 minutes postoperatively, whereas phenylephrine showed higher mean DBP at 20 minutes intraoperatively. These differences were statistically significant, highlighting ephedrine's superiority in maintaining DBP stability across multiple time points. Despite these differences, both drugs ensured hemodynamic stability during cesarean sections. Mean Arterial Pressure (MAP): The mean arterial pressure difference between phenylephrine and ephedrine was statistically significant at the 20-minutes intraoperative time point, with phenylephrine showing higher values. However, at other time points, there was no significant difference in MAP between the two groups. This indicates that both drugs effectively stabilized MAP overall, with phenylephrine exerting a more pronounced effect at 20 minutes intraoperatively. Heart Rate (HR): Ephedrine resulted in a statistically significant higher pulse rate compared to phenylephrine at 5, 10, 20, 30, and 60 minutes intraoperatively. In the postoperative period, the two groups' pulse rate difference was not statistically significant. This reflects ephedrine's known beta-adrenergic effects, which typically lead to increased heart rate, whereas phenylephrine tends to have minimal impact on heart rate. CONCLUSION The choice between phenylephrine and ephedrine should be based on individual patient hemodynamic needs. Phenylephrine may be preferred for maintaining stable SBP during critical phases of cesarean delivery, while ephedrine could be chosen to ensure consistent DBP stability or effectively manage bradycardia. Clinicians should tailor their selection according to specific patient characteristics and hemodynamic goals to optimize outcomes. [ABSTRACT FROM AUTHOR] |
