Comparison of norepinephrine and phenylephrine infusions for maintenance of haemodynamics following subarachnoid block in lower segment caeserean section
| Autor: | Neeru Luthra, Ashima Taneja, Namrata Goyal, Kanika Goel, Anju Grewal |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Bradycardia
business.industry phenylephrine norepinephrine Norepinephrine (medication) Anesthesiology and Pain Medicine Blood pressure Anesthesiology Maternal Hypotension Anesthesia Reflex bradycardia Heart rate medicine RD78.3-87.3 Apgar score Original Article Caesarean section spinal induced hypotension medicine.symptom business Phenylephrine medicine.drug |
| Zdroj: | Indian Journal of Anaesthesia Indian Journal of Anaesthesia, Vol 65, Iss 8, Pp 600-605 (2021) |
| ISSN: | 0976-2817 0019-5049 |
| Popis: | Background and Aims: Phenylephrine is the vasopressor of choice in spinal anaesthesia–induced maternal hypotension. However, it results in reflex bradycardia and decrease in cardiac output (CO), an effect that is perhaps less evident with the use of norepinephrine. We sought to evaluate the effect of phenylephrine and norepinephrine infusion on maternal systolic blood pressure (SBP), heart rate (HR), intraoperative nausea vomiting (IONV) and fatal Apgar scores. Methods: A randomised double-blind study was conducted on 200 American Society of Anesthesiologists (ASA) II–III parturients undergoing caesarean section under subarachnoid block (SAB) who were randomised to two groups A and B to receive variable rate, manually controlled infusions of phenylephrine and norepinephrine targeting maintenance of SBP to 100% of the baseline value. Maternal haemodynamics especially episodes of hypotension, IONV and vasopressor consumption were observed and recorded. Results: A statistically significant trend of lower SBP was observed during the first 6 min following intrathecal injection in group A (P value – 0.000). Though a greater number of parturients experienced ≥1 episode of hypotension in Group A vs Group B (13% vs 9%), the difference was, however, statistically insignificant. The incidence of bradycardia was higher in group A than in group B (16% vs 1%) and was found to be statistically significant (P < 0.05). The episodes of hypertension, IONV, maternal vasopressor consumption and neonatal Apgar score were comparable among both the groups. Conclusion: A dilute solution of norepinephrine infusion is comparably efficacious to the current gold standard vasopressor phenylephrine in maintaining blood pressure following spinal anaesthesia for caesarean delivery, with a significantly lower incidence of bradycardia. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|