Mephentermine vs. Phenylephrine for Prevention and Management of Maternal Hypotension during Caesarean Section under Spinal Anaesthesia and their Effects on Foetal Outcome- A Randomised Control Tria

Autor: Srinivasan Divyabharathi, Sinam Neetu Devi, Jonan Puni Kay, Rakesh Nongthombam, Balusamy Devanathan, Lakshminarayanan Sowrirajan, Adeenpa Chara, Navaneetha Priya Nandinie
Jazyk: angličtina
Rok vydání: 2022
Předmět:
Zdroj: Journal of Clinical and Diagnostic Research, Vol 16, Iss 8, Pp UC09-UC13 (2022)
Druh dokumentu: article
ISSN: 2249-782X
0973-709X
71511857
DOI: 10.7860/JCDR/2022/55818.16708
Popis: Introduction: For the best maternal and foetal outcome during caesarean section under spinal anaesthesia, maintaining Systolic Blood Pressure (SBP) at 100% of the baseline is necessary. Mephentermine and Phenylephrine are both sympathomimetic drugs used for timely correction of maternal hypotension. Aim: To compare the effect of intravenous bolus administration of mephentermine and phenylephrine for prevention and management of maternal hypotension and to evaluate the foetal outcome. Materials and Methods: In this randomised double-blinded controlled trial, a total of 150 American Society of Anaesthesiologist (ASA) II scheduled for elective Lower Segment Caeserean Section (LSCS) were randomly allocated into three groups to receive the study drugs: group A received mephentermine 6 mg in 2 mL Normal Saline (NS), group B received phenylephrine 100 mcg in 2 mL NS, and group C received 2 mL NS immediately following sub-arachnoid block. Whenever hypotension occurred (Systolic Blood Pressure (SBP) 0.05). The time of first rescue vasopressor and the total volume of requirement was earlier and higher in group C with the mean timing of 5.87±4.37 min and mean volume of 2.68±1.58 mL, respectively. Conclusion: There was a significant improvement of arterial blood pressures and better neonatal outcome observed when phenylephrine (100 mcg) and mephentermine (6 mg) are given as a prophylactic intravenous (i.v.) bolus dose immediately after subarachnoid block; especially in the initial time period between skin incision and delivery of the baby. When given as a prophylactic i.v. bolus, it had the advantage of lesser total dose requirement of the vasopressor used and better haemodynamic maintenance till the delivery of the baby.
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