The Iranian Journal of Obstetrics, Gynecology and Infertility

The Iranian Journal of Obstetrics, Gynecology and Infertility

Comparison of the effect of phenylephrine and ephedrine on the neonate in treatment of hypotension due to spinal anesthesia in pregnant women candidate for cesarean section

Document Type : Original Article

Authors
Alireza Pournajafian 1
Faranak Rokhtabnak 1
Mohamadreza Ghodrati 1
Alireza Kholdebarin 2
Ali Hassani 3
Abdolreza Dayani 3
1 Associate professor, Department of Anesthesia, Faculty of Medicine, Iran University of Medical Sciences, Tehran, Iran.
2 Assistant professor, Department of Anesthesia, Faculty of Medicine, Iran University of Medical Sciences, Tehran, Iran.
3 Resident, Department of Anesthesia, Faculty of Medicine, Iran University of Medical Sciences, Tehran, Iran.
10.22038/ijogi.2020.15730
Abstract
Introduction: One of the methods used in cesarean section is spinal anesthesia that have major role in cesarean section. One complication of spinal anesthesia is hypotension. This study was performed with aim to compare the effects of phenylephrine and ephedrine in the treatment of hypotension due to spinal anesthesia in pregnant women who are candidates for cesarean section.
Methods: This randomized, double-blind, clinical trial study was performed on 74 healthy pregnant women candidate for ceasarian section under spinal anesthesia who referred to Firoozgar hospital in Tehran in 2017-2018. Patients were randomly assigned to two groups: phenylephrine or ephedrine. Patients received phenylephrine or ephedrine immediately after hypotension due to spinal anesthesia. During the surgery, hemodynamic variables including systolic, diastolic blood pressure and heart rate were measured every 5 minutes. After the removal of the baby, the umbilical cord blood gases were analyzed; first and fifth minutes Apgar score were recorded. Data were analyzed by SPSS software (version 21) and Repeated measures ANOVA. P<0.05 was considered statistically significant.
Results: There was no significant difference between systolic blood pressure in two groups during surgery (P>0.05). The diastolic blood pressure during surgery at 5, 10, 15, 20, 25 and 30 minutes after the removal of the baby was significantly less in the phenylephrine group than Ephedrine group (P<0.05). Heart rate of patients during surgery except minutes before spinal anesthesia, 6 min after spinal anesthesia, 40 and 45 after the removal of the newborn was significantly less in the phenylephrine group than ephedrine group (P<0.05). First minute Apgar score was significantly higher in phenylephrine group than the ephedrine group (P<0.05). Fifth minute Apgar score was not significantly different between the two groups (P >0.05). There was no significant difference in the PH of newborns in two groups (P>0.05).
Conclusion: Both ephedrin and phenylephrine can be used in treatment of hypotension due to spinal anesthesia in pregnant women candidate for caesarean section, without any significant differences in control of systemic blood pressure and minimum effect on Apgar score.           
Keywords
Apgar
Ephedrine
Hypotension
Phenylephrine
Spinal Anesthesia
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The Iranian Journal of Obstetrics, Gynecology and Infertility
Volume 23, Issue 1
March 2020
Pages 7-18