Comparison of Intravenous bolus Phenylephrine and Ephedrine in the Prevention of Post- spinal Hypotension during Cesarean Section

Spinal anesthesia is a commonly used anesthetic technique for cesarean section. The hypotension is the serious and common complication for it. Prevention of this complication is an important challenge for anesthesiologists.

The aim of this study is to compare the effect of prophylactic bolus injection of Phenylephrine and Ephedrine in the prevention of hypotension during spinal anesthesia in elective cesarean section.

In this double-blind randomized clinical trial, in order to prevent hypotension in cesarean section, 80 pregnant women who were candidates for elective cesarean section were randomly assigned to two groups (Phenylephrine or Ephedrine). Immediately after spinal anesthesia, the first group received 10 mg ephedrine and in the second group, 100 micrograms of phenylephrine was injected bolus intravenously.Both groups were evaluated for nausea and vomiting, systolic, diastolic, mean arterial pressure, heart rate and SPO2 at specific intervals. The neonatal Apgar score was evaluated at first and fifth minutes after birth. The collected data were analyzed by SPSS software version 16 at 95% confidence interval.

Although nausea and vomiting, systolic, diastolic and mean arterial pressure were higher in the Ephedrine group than the Phenylephrine group, there were no significant differences between the two groups. There was also no significant difference between two groups in incidence of mean heart rate and SPO2 during surgery. There was no significant difference in neonatal Apgar score at first and fifth minutes between them.

In cesarean section, intravenous bolus injection of Phenylephrine without affecting the incidence of maternal nausea and vomiting and neonatal Apgar score, such as Ephedrine is effective in the prevention of hypotension following spinal anesthesia.