Comparison of Intravenous bolus Phenylephrine and Ephedrine for prevention of postspinal Hypotension during Cesarean section.

Comparison of intravenous injection of phenylephrine and ephedrine in preventing post spinal hypotension in cesarean section

80 patients were randomly assigned to a double blind randomized phase 4 clinical trial. They are randomly placed in 4 blocks and enter into one of two ephedrine (A) and phenylephrine (B) groups.

After spinal anesthesia in candidates for C/S in Fatemieh hospital of Hamedan, they are placed in a supine position and in one of two groups A (10 mg ephedrine) or B (100 μg phenylephrine) .Both medicines are prepared by an anesthetist nurse who does not have information from the groups in syringes of the same shape and volume, and injected intravenously, in which anesthetist and patient are not familiar with the type of medication prescribed

Inclusion criteria: Patients aged 18 to 45; healthy and candidates for C/S under spinal anesthesia. Exclusion criteria: Cardiac disease; Renal disease; Hypertension; Diabetes; Eclampsia and pre-eclampsia; Multiple pregnancy; Candidates for emegency C/S and spinal anesthesia contraindications.

Patients were restored to supine position after spinal anesthesia and in group A 10 mg ephedrine and group B 100 microgram phenylephrine, is prepared with the same shape and volume, by an anesthetist nurse and is injected intravenously.

Systolic; Diastolic blood pressure; Mean arterial pressure; heart rate and SPO2 in 0, 2, 4, 6, 8, 10, 15, 20, 25, 30, 40, 50, 60 minutes; nausea and vomiting; first and fifth minutes Apgar score and consum ephedrine and atropine are registered.

In this study, the randomization method is used as a 4-blocks. In this way, according to the sample size, 20 blocks of four are identified, and in each of these blocks of four, two of each group will be written in the form of letters A or B. This means that two A and two B are written in each block, although the order of the writing of the four letters A and B will be different in each block. The periodic numbers table will then be used to determine the order of block selection.

Ephedrine (10 mg) and phenylephrine (100 μg) in the same volumes (1 ml) are prepared in the same syringes by the anesthetist nurse according to the list of patients entered into the study (based on the four blocks) and then administered intravenously after spinal anesthesia. . Therefore, the anesthetist, the patient and the person evaluating the outcome (anesthetist) are not familiar with the type of prescribed medication