Evaluation of the comparative effect of hemodynamic changes due to prophylactic Prescription of phenylephrine in three forms: bolus, subcutaneous and infusion in mothers with selective cesarean section under spinal anesthesia with marcaine

Determining the comparative effect of hemodynamic changes due to prophylactic administration of phenylephrine in three forms of bolus, subcutaneous and infusion in mothers with elective cesarean section under spinal anesthesia with marcaine

A clinical trial study on three intervention groups receiving phenylephrine in the form of bolus, subcutaneous and infusion with the control group. There are 30 people for each group. The study is a blind and randomized block study.

Background: Anesthesia Location: Operating room of Ilam city hospitals Methods: Evaluation of hemodynamic changes before, during and after prophylactic phenylephrine injection and also in the control group method : Subcutaneous: 5 to 10 minutes before anesthesia, 5 mg phenylephrine at the site of deltoid Infusion: 1 to 2 minutes before anesthesia µg / kg / min0.15 phenylephrine for 30 minutes Bolus: 1 to 2 minutes before anesthesia 1/5 µg / kg Control group: no injection and in cases with pressure drop phenylephrine bolus and stat How to blind: The researcher does not know about the intervention performed for each case when recording data

Inclusion: Single term pregnant women 18 to 35 years old at the risk of anesthesia I and II of the American Anesthesia Association who are candidates for elective cesarean section Exclusion: Women with a history of high blood pressure (BP> 140/90), diabetes, cardiovascular and cerebral disease, known fetal abnormalities, any contraindications to spinal anesthesia, and mothers at the beginning of the labor phase

Bolus, infusion, subcutaneous and control in 3 intervention groups, prophylactic administration is performed, but not in the control group

Blood pressure ; Heart beat ; Apgar score; Arterial blood test results including PH, Paco2, Base excess and HCO3

After completing the baseline assessment, patients were divided into three intervention groups and one control group. Randomization was performed using the block method (with block size of 4 or 6 and allocation ratio of 1: 1). Block randomization is used to reduce bias and achieve equilibrium in allocating participants to the study groups. Random allocation concealment was performed using opaque sealed envelopes with random sequences. Random allocation sequence is done using a computer-generated Kendall and Smith random number table. These tables have random numbers in both row and column directions, usually up to 99 rows and columns, and row and column digits. The cells are placed in five-digit blocks next to each other and separately to facilitate its use. This step is performed by a statistician who is not part of the research team. The random allocation sequence was hidden in closed opaque envelopes so that participants were assigned to 4 groups.

The anesthesiologist and other members of the treatment staff and participants in the study are informed but the researcher is not As follows: Participants will be notified upon consent According to the decision of the anesthesiologist, one of the intervention methods is selected and after the prescription, the researcher, who is not aware of the prescription method, starts recording the data.