Comparison between ephedrine and phenylephrine in the prevention of post spinal hypotension during elective cesarean section

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 μgm 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.