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Objective: To compare the effectiveness and safety of ephedrine compared with phenylephrine given prophylacticaly
in the prevention of maternal hypotension during spinal anaesthesia for elective cesarean delivery.
Material and Methods: This study was conducted in the Department of Anesthesia at Khyber Teaching Hospital,
Peshawar during a period of one year. The study design was randomized controlled trail. 134 patients under going
elective cesarean section by spinal anaesthesia were randomly divided into two groups. Group E (n = 67) received
prophylactic dose of ephedrine 10mg IV and group PE (n = 67) received prophylactic Phenylephrine 80 ?gm IV.
Hypotension (blood pressure < 80% of baseline value) was treated with bolus administration of vasoconstrictor at
50% of initial dose. Incidence of hypotension, reactive hypertension, bradycardia, nausea vomiting and apgar score
(in 1st and 5th minute) were evaluated.
Results: Demographic parameters such as age, weight and American Society of Anestheslogist (ASA) class, had
similar distribution in both the groups. Hypotension was found higher in phenylephrine group which was 34.3% while
28.4% in ephedrine group although statistically it was found insignificant with p-value=0.288 with chi square test. The
incidence of nausea, vomiting and bradycardia were found higher in phenylephrine group. The apgar score was
equal in both groups after 1st and 5th minute.
Conclusion: Ephedrine was found to be more effective than phenylephrine in the prevention of maternal
hypotension and with fewer side effects.
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