Comparative evaluation of intravenous bolus of phenylephrine versus intravenous bolus of noradrenaline for treatment of hypotension in patients undergoing elective caesarean section

Divakar SR, Shivakumar G, Kiran AV, Kavya D

Pdf Page Numbers :- 27-31

Divakar SR¹, Shivakumar G¹, Kiran AV¹ and Kavya D^1,*

¹Department of Anaesthesia, Mandya Institute of Medical Sciences, Mandya, Karnataka 571401, India

*Corresponding author: Dr. Kavya D, Department of Anaesthesia, Mandya Institute of Medical Sciences, Mandya, Karnataka 571401, India. Email: kavyad996@gmail.com

Received 18 September 2024; Revised 15 November 2024; Accepted 26 November 2024; Published 10 November 2024

Citation: Divakar SR, Shivakumar G, Kiran AV, Kavya D. Comparative evaluation of intravenous bolus of phenylephrine versus intravenous bolus of noradrenaline for treatment of hypotension in patients undergoing elective caesarean section. J Med Sci Res. 2025; 13(1):27-31. DOI: http://dx.doi.org/10.17727/JMSR.2024/13-5

Copyright: © 2025 Divakar SR et al. Published by KIMS Foundation and Research Center. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

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Abstract

Introduction: Hypotension after spinal anaesthesia for an LSCS is frequent even with sufficient fluid replacement. Phenylephrine is suggested for managing hypotension in caesarean sections. Our study aimed to analyse the efficacy of bolus norepinephrine doses in comparison with phenylephrine in treating spinal hypotension during elective caesarean section.

Methods: This randomized double-blind study was performed at Mandya Institute of Medical Sciences, Mandya. 160 patients of age group 20–30 years posted for elective caesarean section were divided into two equal groups (A and B) using computer generated number system. Group A received injection phenylephrine 50mcg bolus dose while Group B received injection noradrenaline 4mcg for treating hypotension. The aim was to assess the quantity of bolus doses of phenylephrine and noradrenaline needed to address spinal hypotension. The examination of the frequency of negative effects on maternal and foetal parameters was the secondary aim.

Results: The hypotension in Group A was treated with lower dose of vasopressor compared to Group B (52.50±10.966 vs 8.15 ± 1.571) and the difference was found to be statistically significant with p value 0.002. Incidence of bradycardia seen in Group A was comparable with Group B, but statistically not significant. Maternal complications and fetal parameters were comparable between two groups.

Conclusion: Intermittent boluses of phenylephrine are effective in the management of spinal hypotension during elective caesarean section. The maternal complications and fetal parameters were comparable in both the groups. Phenylephrine boluses can be considered in treating post spinal hypotension during elective caesarean sections.

Keywords: caesarean section; hypotension; norepinephrine; phenylephrine; vasopressors