Observational cohort study on Effectiveness of prophylactic bolus phenylephrine on the prevention of post-spinal hypotension during elective caesarean section at Ghandi Memorial Hospital, from February 01/2024 to May 15/2024 G.C
No Thumbnail Available
Date
2024-05
Authors
Journal Title
Journal ISSN
Volume Title
Publisher
Addis Ababa University
Abstract
Introduction: Spinal anaesthesia owing to the perceived advantages is commonly used for
caesarean section. However parturients under spinal anaesthesia frequently experience
hypotension and if it is severe it can result in morbidity for both the mother and the fetus. The
incidence of hypotension during spinal anaesthesia for caesarean section is reduced by
administering intravenous fluids, drugs such as vasopressors, or by leg elevation. But in the
practice of anaesthesia preventing and treating hypotension associated with spinal anaesthesia
continue to be a challenging issue and there is controversy about the best way to handle it.
Objective: The objective of this study is to determine the effectiveness of prophylactic
bolus phenylephrine on the prevention of post-spinal hypotension during elective caesarean
section under spinal anaesthesia.
Method: Observational cohort study design was conducted at Gandhi Memorial Hospital
located in Addis Ababa,Ethiopia from February 01, 2024 to May 15, 2024. The sample size
was determined by using the double population proportion method using manual calculator.
Statistical package for social sciences (SPSS) software version 27.0 was used for data
analyses. Comparison of numerical data between study groups was done by using
independent sample t- test for symmetrical data and Mann whitney U test was used to
compare non parametrical data. Chi square test was used to compare categorical data of the
group. Values are presented as mean SD for symmetric data and median (IQR) for
asymmetric data. For categorical data values are presented by number percent. Significance
was determined at P value <0.05.
Result: The incidence of hypotension in standard care group was 63.3% but in
phenylephrine prophylactic group the incidence of hypotension was 28.6% [N: 105), P:
0.004]. Starting from the induction until 25th minute, phenylephrine group had higher mean
value of systolic and diastolic blood pressure than standard care group (P<0.05). Incidence of
nausea, incidence of vomiting, numbers of mothers that require rescue vasopressor and total
dose of rescue vasopressor were significantly different between the groups. Heart rate
differences between phenylephrine and standard care group were not statistically significant
Conclusion and recommendation: In conclusion, parturient undergoing elective
caesarean section experienced less episode of hypotension after spinal anaesthesia when a
prophylactic bolus phenylephrine was used. Administering 100 microgram of bolus
phenylephrine immediately after spinal anaesthesia is recommended for better hemodynamic
stability of the mothers
Description
Keywords
Spinal anaesthesia, Caesarean section