2025, Vol. 8, Issue 1, Part A
Efficacy of phenylephrine in preventing hemodynamic responses of oxytocin during caesarean section under spinal anaesthesia: A randomized comparative study
Author(s): Faizal Rafik Kureshi, Shobhana Gupta, Bharti Rajani, Urvashi Patel, Mukund Patel
Abstract: Introduction:Postpartum hemorrhage (PPH) is a major cause of maternal morbidity and mortality, with uterine atony being the leading cause. Oxytocin is the first-line uterotonic for PPH prevention but can cause significant hypotension and tachycardia. This study evaluates the efficacy of two different doses of phenylephrine, 75 μg and 100 μg, in preventing oxytocin-induced hypotension during caesarean section under spinal anaesthesia, focusing on its effects on blood pressure, heart rate, and the need for rescue vasopressors.
Methods: This study involved 180 full-term pregnant women aged 18-35, it used a randomized, double-blind, controlled design with three groups: Group P75 (75 μg phenylephrine), Group P100 (100 μg phenylephrine), and Group NS (normal saline). Phenylephrine was administered just before IV oxytocin (3U) following cord clamping. Hemodynamic parameters, incidence of hypotension, need for rescue vasopressors, and side effects were recorded.
Results: While the mean age, weight, and height were similar across all groups, Phenylephrine administration significantly reduced oxytocin-induced hypotension. The incidence of hypotension was 8.3% in P75, 3.3% in P100, and 20% in NS (p=0.001). The mean dose of rescue vasopressors required was 45.1 μg in P75, 30.0 μg in P100, and 51.6 μg in NS (p<0.001). Group NS had the highest hypotension rate and required the most vasopressor, followed by Groups P75 and P100. Group P100 maintained the most stable hemodynamic profile with minimal side effects compared to Group P75 and Group NS.
Conclusion:Prophylactic administration of phenylephrine, particularly at 100 μg, significantly reduces oxytocin-induced hypotension during caesarean section under spinal anaesthesia. This strategy may enhance maternal hemodynamic stability, reducing the need for additional rescue vasopressor interventions.
DOI: 10.33545/26643766.2025.v8.i1a.541
Pages: 20-24 | Views: 80 | Downloads: 39
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How to cite this article:
Faizal Rafik Kureshi, Shobhana Gupta, Bharti Rajani, Urvashi Patel, Mukund Patel. Efficacy of phenylephrine in preventing hemodynamic responses of oxytocin during caesarean section under spinal anaesthesia: A randomized comparative study. Int J Med Anesthesiology 2025;8(1):20-24. DOI: 10.33545/26643766.2025.v8.i1a.541
