Abstract :
Introduction: Hypotension is a common side effect when neuraxial analgesia is administered to the
obstetric population. To find out the efficacy of mephentermine and phenylephrine for management
of hypotension following spinal anesthesia in cesarean section. The study has been undertaken at the
Department of Anesthesiology of ESI- PGIMSR, Manicktala, Kolkata, after obtaining approval from
Institute Ethical Committee
Study Design: Uni-centric randomized, single blind, prospective & comparative study
Statistical Analysis Used: Unpaired Student’s t-test, chi-square test, Fisher’s exact test
Materials and Methods: The 40-female scheduled for elective caesarean section were randomly divided
into two groups of 20 each. Subarachnoid block was performed with 2.2mL of 0.5% hyperbaric
bupivacaine. Prophylactic infusion of vasopressor started at a rate of 60 ml/h 0f 50 mcg/min for
phenylephrine (group P, n=20) and 600 mcg/min for mephentermine (Group M, n=20) Hemodynamic
parameters were monitored. At the end of surgery and the patients were transferred to the postoperative
care unit (PACU).
Results: Considering absolute values of hypotension, both groups are comparable in terms of preventing
hypotension; however, phenylephrine had better control of maintenance over blood pressure than that
of mephentermine. Reactive hypertension is common in phenylephrine infusion. Bradycardia is more
prevalent in phenylephrine infusion than that of mephentermine while tachycardia is more common in
mephentermine. Side effects like dyspnea, nausea/vomiting, headache is more common during hypotensive
episodes. None of the drugs causes any untoward effect on fetus.
Keyword :
Phenylephrine, Mephentermine, Intraoperative hypotension, Procedural Sedation, Spinal Anesthesia.