COMPARISON OF PROPHYLACTIC PHENYLEPHRINE INFUSION VERSUS BOLUS REGIMENS ON MATERNAL HEMODYNAMICS DURING CESAREAN SECTION

Abstract

Objective: To compare mean systolic blood pressure for 45 minutes after giving spinal anesthesia between prophylactic phenylephrine group and bolus regimens in patients undergoing spinal anesthesia for cesarean section.

Study Design: Randomized Controlled Trial.

Place & Duration: Six months w.e.f. 06-06-2024 to 05-12-2024 at Department of Anesthesia, Hameed Latif Hospital, Lahore.

Methodology: After approval from the ethical review committee, 60 patients were randomly assigned to two groups. Baseline vitals, including systolic blood pressure, were recorded, and all patients received a 10 mL/kg normal saline bolus. Spinal anesthesia was administered with 12 mg of hyperbaric 0.75% bupivacaine. Group A received a prophylactic phenylephrine infusion, while Group B received phenylephrine bolus upon hypotension. Blood pressure was monitored at regular intervals. Data were analyzed using SPSS, with statistical significance set at p ≤ 0.05.

Results: This study involved 60 participants with a mean maternal age of 27.05 years. Most participants were aged 18-30 years (65.0%), and 43.6% were in the >39-week gestational age range. The mean BMI was 25.82 kg/m², with 43.6% categorized as overweight or obese. Both groups were comparable at baseline. At 45 minutes, Group A had a significantly higher SBP than Group B, with differences observed across age, gestational age, and BMI subgroups, indicating better hemodynamic control in Group A.

Conclusion: The study demonstrated that prophylactic phenylephrine infusion maintained a more stable and higher systolic blood pressure compared to the bolus regimen at 45 minutes post-intervention. This finding suggests that a continuous infusion may offer better hemodynamic control during cesarean sections