What is it about?
Comparison of Vasopressor Effects of Phenylephrine and Mephenteramine During Spinal Anaesthesia
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Why is it important?
Caesarian sections are mostly done under regional anaesthesia, especially spinal anaesthesia, in many places. Many of the patients develop hypotension after spinal anaesthesia. A fall in blood pressure of more than 20% from baseline value is hazardous to both mother and the baby. Various methods had been tried to alleviate this response. Preloading with crystalloid solution, maintaining a left lateral tilt, elevating the foot end, and pharmacological therapy using vasopressors are all tried. Common vasopressors used are Mephenteramine and Ephedrine. Now Phenyl ephrine is the vasopressor of choice. Here we are looking at the prophylactic effect of phenylephrine given intravenously along with spinal anaesthesia, and comparing the property with intravenous Mephenteramine given prophylactically along with spinal anaesthesia in full term pregnant subjects. All our subjects were aged between 18 to 40 years, weighing less than 70 kg, satisfying ASA1 criteria. Development of side effects like nausea, vomiting, retrosternal discomfort was also noted. Our subjects who received prophylactic vasopressors supported haemodynamic status of the subjects effectively till the delivery of the baby. Subjects who received intravenous phenyl ephrine developed a transient fall in heart rate which got corrected by itself. None of our subjects developed any hazardous side effects.
Perspectives
Caesarian sections are mostly done under regional anaesthesia, especially spinal anaesthesia, in many places. Many of the patients develop hypotension after spinal anaesthesia. A fall in blood pressure of more than 20% from baseline value is hazardous to both mother and the baby. Various methods had been tried to alleviate this response. Preloading with crystalloid solution, maintaining a left lateral tilt, elevating the foot end, and pharmacological therapy using vasopressors are all tried. Common vasopressors used are Mephenteramine and Ephedrine. Now Phenyl ephrine is the vasopressor of choice. Here we are looking at the prophylactic effect of phenylephrine given intravenously along with spinal anaesthesia, and comparing the property with intravenous Mephenteramine given prophylactically along with spinal anaesthesia in full term pregnant subjects. All our subjects were aged between 18 to 40 years, weighing less than 70 kg, satisfying ASA1 criteria. Development of side effects like nausea, vomiting, retrosternal discomfort was also noted. Our subjects who received prophylactic vasopressors supported haemodynamic status of the subjects effectively till the delivery of the baby. Subjects who received intravenous phenyl ephrine developed a transient fall in heart rate which got corrected by itself. None of our subjects developed any hazardous side effects.
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This page is a summary of: Comparison of Vasopressor Effects of Phenylephrine and Mephenteramine during Spinal Anaesthesia for Ceasarian Section, Indian Journal of Anaesthesia and Analgesia, June 2020, Red Flower Publication Private, Ltd.,
DOI: 10.21088/ijaa.2349.8471.7320.23.
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