Phenylephrine Effectiveness in Handling Hypotensive Issues During Spinal Anesthesia Conductance for Cesarean Section Deliveries

Abstract

Mohamed Sayed Fahim

Background: Hypotension is frequent clinical challenge during spinal mode of anesthetic induction for cesarean delivery. Requiring an effective and prompt management mode since it has unfavorable clinical outcomes such as hemodynamic cardiovascular instability issues besides reduced uteroplacental perfusion.

Aim: Investigating the impact and effectiveness of different prophylacticdosages of Phenylephrine on hypotensive issues during spinal anesthesia for cesarean section deliveries.

Methodology:A prospective, randomized, clinical research study involved 184 cases That are classified as American Society of Anesthesiologists physical status I and II with term singleton pregnancies scheduled for elective cesarean section under spinal anesthesia randomized to receive 0.9% saline 2 mL (Control Group) or phenylephrine1.0 ug/kg (PHE1 research Group), 1.5 ug/kg (PHE1.5 research Group), or 2.0 ug/kg (PHE2 research Group) immediately after induction of spinal anesthesia.

Results: The adverse effects of prophylactic bolus ofPhenylephrine among the research groups control, Phenylephrine 1, 1.5,2 in which there was statistically significant difference as regards hypotension, rescue Phenylephrine,lowest SBP,highest SBP,early highest SBP,mean SBP, occurrence of hypertension (p values= <0.001, <0.001, 0.002, <0.001, <0.001, <0.001, <0.001consecutively) there was no statistical significant difference as regards nausea and bradycardia (p values=0.929, 0.823consecutively).

Conclusions: The research findings obtained denote and imply that a prophylactic Phenylephrine 1.5 ug/kg bolus followed by additional boluses when necessary could be an alternative management protocol to decrease the frequency of hypotensive issues occurrence during spinal anesthetic mode for cesarean deliveries.

PDF