Assessment of E?ect Phenylephrine with Oxytocin on the Prevention of Oxytocin-Induced Hypotension in Caesarean Section Under Spinal Anaesthesia

Prevention of Oxytocin-Induced Hypotension in Caesarean Section

Abstract

Background: The aim is to assess the effect of co‑administration of different doses of phenylephrine with oxytocin on the prevention of oxytocin‑induced hypotension in caesarean section under spinal anaesthesia. Subjects and Methods : Forty- eight adult females in age ranged 18- 48 years with elective and emergency lower segment caesarean section (LSCS) were recruited and were classified into 3 groups of 16 each based on lottery method. Group I patients received oxytocin 3U and phenylephrine 50 g diluted to 10 cc with normal saline as an infusion over 5 minutes, group II patients received oxytocin 3U and phenylephrine 75 g diluted to 10 cc infusion over 5 minutes and group III patients received oxytocin 3U and normal saline diluted to 10 cc infusion over 5 minutes. Parameters such as height, weight, sensory block, duration   of surgery (minutes), extraction time of baby from induction (minutes) and extraction time of baby from skin incision (minutes), incidence of hypotension and dose of rescue vasopressor given was recorded and compared in all groups. Results: The mean age in group I was 27.2 years, in group II was 28.4 years and in group III was 28.1 years. The mean height was 161.2 cm in group I, 160.5 cm in group II and 162.1 cm in group III. The mean weight was 65.4 kgs in group I, 64.2 kgs in group II and 66.5 kgs in group III. A non- significant difference was observed in all three groups (P> 0.05). The duration of surgery found to be 52.3 minutes in group I, 53.2 minutes in group II and 52.8 minutes in group III. Extraction time of baby from induction was 10.8 minutes, 10.9 minutes and 11.2 minutes and extraction time of baby from skin incision was 6.5 minutes, 7.2 minutes and 7.8 minutes in group I, II and III respectively. Dose of rescue vasopressor given (g) was 42.3, 5.7 and 91.2. Incidence of hypotension was seen in 13, 2 and 14 and episodes of hypotension was 0 seen in 14 in group II, 1 seen in 11, 2 and 13 and 2 seen in 2, 0 and 1, MAP before oxytocin infusion was 81.2, 81.2 and 76.2 and MAP after oxytocin infusion was 65.2, 74.9 and 64.9 in group I, II and III respectively. Conclusion: Results showed that co-administration of phenylephrine 75 g with oxytocin 3U reduces the incidence of oxytocin-induced hypotension compared to phenylephrine 50 g with oxytocin 3U during caesarean section under spinal anaesthesia.