COMPARISON BETWEEN INTRAVENOUS PHENYLEPHRINE INFUSION AND FLUID CO-ADMINISTRATION VERSUS FLUID PRE-LOADING ONLY ON SPINAL INDUCED HYPOTENSION

Abstract

Objective: To compare the incidence of hypotension seen after spinal anesthesia during lower section caesarian section (LSCS) when pre-loading with intravenous infusion of phenylephrine with fluid co-administration versus pre-loading with fluid co-administration alone

Study Design: Quasi-experimental study

Place and Duration of Study: Anesthesia department of Combined Military Hospital, Kharian from June 2024-November 2024.

Methodology: The patients were divided into Group P (n=150), to receive IV Phenylephrine with fluid co-administration and Group F (n=150) receiving fluid pre-loading only. Primary variable studied was the incidence of hypotension between both groups and the total dose of IV Phenylephrine used as rescue analgesia. Secondary variables measured were mean values for arterial pressure and heart rate between both groups.

Results: Incidence of hypotension was seen in 42 (28%) patients immediately after spinal in Group P versus 76 (50.7%) patients in Group F (p<0.001). Total mean dose used in both groups was 346.19±27.29 mcg in Group P versus 444.33±90.40 mcg in Group F (p<0.001). The highest mean value for arterial pressure was 88.01±1.97 mm Hg in Group P versus 87.86±1.13 in Group F (p=0.432) while the lowest mean arterial pressure values were 70.15±4.78 mm Hg in Group P versus 61.84±5.23 mm Hg in Group F (p<0.001).

Conclusion: We conclude that IV Phenylephrine co-administration as an infusion with fluid results in better hemodynamic stability, less use of rescue vasopressor and decreased incidence of post-spinal hypotension