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International Journal of Recent Trends in Science and Technology, ISSN 2277-2812 E-ISSN: 2249-8109
Volume 12, Issue 1, September 2014 pp 137-140
Evaluation of pre-emptive intramuscular phenylephrine at different dose for reduction of hypotension under spinal anaesthesia
Ramesh R.1, Dayananda V. P.2, Bhaskara R.3
1,2,3Assistant Professor, Department of Anaesthesiology, BMC and RI, Bangalore, Karnataka, INDIA.
Background: Incidence of hypotension is a common sequelae following Spinal anesthesia (SAB). Phenylephrine, a selective alpha1 adrenergic agonist raises arterial pressure by causing vasoconstriction. In this study we have evaluated Phenylephrine 4 mg and Phenylephrine 2 mg I.M., administered immediately after induction of SAB in terms of incidence of hypotension, requirement of rescue ephedrine and time to first ephedrine administration. Methods: In present study preemptive intramuscular (I.M.) Phenylephrine drug administration were evaluated in 120 patients assigned to two groups (60 each) in a randomized study undergoing elective lower abdominal and lower limb surgeries under Spinal anesthesia. Group I (p4) received preemptive Phenylephrine 4 mg i. m. and group II (p2) received preemptive Phenylephrine 2 mg I.M., both given immediately after induction of Spinal anesthesia. In this study, hypotension was defined as a 25% decrease in MAP and hypertension as a 25% increase in MAP. Rescue intravenous (I.V.) boluses of ephedrine were given if the patient was hypotensive. Results: The incidence of hypotension was only 25% in P4 mg group compared to 46.66% in P2 mg group (p=0.01). The P4 mg group had a significantly lower percentage reduction in MAP compared with P2 mg group (p=0.01). Conclusion: We conclude that preemptive I.M. Phenylephrine 4 mg reduces the severity of hypotension following Spinal anesthesia.