Comparison of Prophylactic Infusion of Phenylephrine and Ephedrine for the Prevention of Hypotension in Elective Lower Segment Caesarean Section Under Spinal Anesthesia.

Abstract

Hypotension is the primary adverse outcome associated with spinal anesthesia during cesarean delivery, potentially leading to adverse effects
in mothers and acid-base imbalances in newborns. It is widely acknowledged that efficient intervention is crucial to prevent any negative impact on fetal
birth. Administering anesthesia to pregnant women requires the highest level of care, as the anesthesiologist must consider the well-being of both the
mother and the fetus. The primary side effect of spinal anesthesia during a cesarean birth, which could lead to unfavorable symptoms in the mother and
acid-base consequences in the newborn, is hypotension. Phenylephrine and ephedrine are known for their efficacy in preventing hypotension following
spinal anesthesia. This study aims to assess the effectiveness of prophylactic infusions of phenylephrine and ephedrine in averting hypotension during
elective lower-segment cesarean sections under spinal anesthesia. Examining the impact of prophylactic infusions of phenylephrine and ephedrine as
vasopressors. Treatments during Unconsciousness originating in the spinal cord for cesarean sections and their impact on infant outcomes were
investigated. We found that both Ephedrine and phenylephrine effectively managed systolic, diastolic, and mean arterial pressure. The ephedrine group
needed a significantly higher number of additional boluses than the phenylephrine group (p value<0.001). The phenylephrine group exhibited a more
favorable pH and lower acidosis levels than the ephedrine group (p-value 0.05). Prophylactic administration of phenylephrine at a dosage of 15 mcg/min
proved more effective in sustaining arterial blood pressure following spinal anesthesia for cesarean delivery than Ephedrine at 1.5 mg/min, and this effected
reduced acidosis in newborns.