Abstract:
Background: Hypo tension is one of the common complications of spinal anesthesia. It has many detrimental
effects to the mother and fetus if left untreated. Recently, phenylephrine is introduced for the treatment of
hypo tension in our hospital. However, its efficacy on the prevention of spinal anesthesia induced hypo tension is still
under controversy. We aimed to assess the effectiveness of phenylephrine prophylaxis on spinal hypo tension after
caesarean section.
Methods: A prospective observational study was conducted at the University of Gondar Hospital. Patients were
allocated based on treatment received; 50/100 µgm phenylephrine prophylaxis vs. no prophylaxis. PR, SBP, DBP,
SPO2 and APGAR score were measured before, immediately after spinal anaesthesia, every 2 min intra operatively
till the delivery of the baby and every 5 min after delivery for 20 min, and every 10 min for 1 h in postoperative
period.
Results: The incidence of hypotension was significantly lower for those participants with prophylactic
phenylephrine (26% vs. 81.6%, p<0.001) compared to the non-treatment group. Systolic and diastolic blood
pressures immediately after spinal anaesthesia till delivery and after delivery of the baby were significantly lower in
the none treatment group at all times (p<0.05). Moreover, the number of rescue treatments and total amount of fluid
given during the intraoperative period for the treatment of hypotension were more in the non-treatment group
P=0.001). The APGAR scores at 1 and 5 min and postoperative vital signs were comparable between groups.
Conclusion and recommendation: The incidence of spinal anaesthesia induced hypotension was high.
Prophylactic intravenous phenylephrine bolus remarkably reduced the incidence of spinal induced hypotension
compared to the non-treatment group. We recommend prophylactic phenylephrine for parturients undergoing
caesarean section under spinal anaesthesia. Moreover, other pharmacological and non-pharmacological methods
need to be considered as the incidence of hypotension is still high in the treatment group.
