Comparison between two different doses of Norepinephrine infusion for preventing post spinal Anesthesia Hypotension during Cesarean section

Authors

  • Rupak Bhattarai Nobel Medical College Teaching Hospital https://orcid.org/0000-0002-5521-081X
  • Amarendra Kumar Yadav Nobel Medical College Teaching Hospital
  • Parasmani Shah Nobel Medical College Teaching Hospital
  • Prabin Sharma Nobel Medical College Teaching Hospital

DOI:

https://doi.org/10.3126/bjhs.v8i2.59851

Keywords:

Apgar score, Cesarean, Norepinephrine, Post spinal hypotension

Abstract

Introduction:  Post spinal maternal hypotension is common complication during cesarean section. Norepinephrine is a vasopressor recently used in obstetrics anesthesia. However, there are less data available regarding its optimal dose.

Objective: The main objective of this study is to compare two doses of infusion of norepinephrine for post spinal hypotension during cesarean delivery.

Methodology: A prospective, randomized, double blinded study on full term pregnant patient scheduled for elective cesarean delivery. The infusion of Norepinephrine started after spinal anesthesia after patient randomly divided into two groups. Group A received norepinephrine infusion rate of 0.025ug/kg/min and Group B received at rate of 0.050ug/kg/min. The norepinephrine was continued till 5 minutes after the delivery of fetus and subsequently stopped. These two groups were compared with systolic blood pressure, mean arterial pressure, heart rate, intraoperative hypotensive episodes, Nausea and Vomiting, tachycardia and neonatal outcomes.

Results:  Systolic blood pressure and mean arterial pressure was higher in group B when compared with group A at all time intervals intraoperatively. The minimum systolic blood pressure and mean arterial blood pressure in group A were 91.61±8.76 and 59.8±5.29 and group B were 90.67±1.21 and 65±3.46 respectively. No significant difference in heart rate between the two groups. In 0.025ug/kg/min group had 23 (46%) hypotensive episode whereas in 0.050ug/kg/min group had 6 (12%) hypotensive episodes (p<0.001). In group A 9 patient had nausea and vomiting. Bradycardia was seen in 2 % of patient in group A. Tachycardia was seen in 4% of patients in group B. Apgar score was comparable and significant (P<0.05) in 10 minutes.

Conclusion: In the present study, the infusion of  0.050ug/kg/min norepinephrine reduced the hypotensive episodes when compared with the infusion of 0.025ug/kg/min norepinephrine following spinal Anesthesia during cesarean delivery.

Downloads

Download data is not yet available.
Abstract
33
PDF
52

Author Biographies

Rupak Bhattarai, Nobel Medical College Teaching Hospital

Associate Professor, Deapartment of Anesthesiology

Amarendra Kumar Yadav, Nobel Medical College Teaching Hospital

Consultant, Department of Anesthesiology

Parasmani Shah, Nobel Medical College Teaching Hospital

Lecturer, Deapartment of Anesthesiology

Prabin Sharma, Nobel Medical College Teaching Hospital

Junior Resident, Deapartment of Anesthesiology

Downloads

Published

2023-11-27

How to Cite

Bhattarai, R., Yadav, A. K., Shah, P., & Sharma, P. (2023). Comparison between two different doses of Norepinephrine infusion for preventing post spinal Anesthesia Hypotension during Cesarean section. Birat Journal of Health Sciences, 8(2), 2014–2018. https://doi.org/10.3126/bjhs.v8i2.59851

Issue

Section

Original Research Articles