Intraoperative requirement of Phenylephrine for spinal anaesthesia, with comparison of hemodynamic parameters between severe pre-eclamptic and normotensive parturients for elective caesarean section: A prospective study

Aim: The aim of this study is to assess the efficacy and safety of spinal anaesthesia by comparing the severity of hypotension and intraoperative requirement of Phenylephrine to treat it in severe pre-eclamptic and normotensive parturients undergoing elective caesarean section. Materials and Methods: A total of 50 parturients, 25 each of normotensive and pre-eclamptic were given spinal anaesthesia with 12.5mg of hyperbaric bupivacaine after preloading with 10ml/kg of Ringer lactate solution. The vitals namely heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP), and the mean arterial blood pressure (MAP) were monitored during caesarean section. Severity of hypotension and the mean requirement of Phenylephrine to manage this hypotension were compared in the two groups. Foetal outcome was compared in two groups by studying the Apgar score. Results: There was statistically less hypotension following spinal anaesthesia and less requirement of vasopressor in pre-eclamptic as compared to normotensive parturients. The mean requirement of Phenylephrine was 156.3±62µg in normotensive (group I) and comparatively more than the requirements of pre-eclamptic (group II) parturients and was statistically significant (p<0.05). The Apgar score at 1 and 5 minutes were equal in both the groups. Conclusion: Spinal anaesthesia is ideal and safe option for severe pre eclamptics undergoing elective caesarean section without any additional risk to baby.