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Comparison of intermittent intravenous bolus of phenylephrine and noradrenaline in management of spinal anesthesia induced hypotension in elective cesarean section: A randomized controlled trial

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Original Article

Author Details : Shalini Das, Sankar Roy, Bani Parvati Magda Hembrom, Dipasri Bhattacharya, Arpita Choudhury*

Volume : 12, Issue : 1, Year : 2025

Article Page : 139-144

https://doi.org/10.18231/j.ijca.2025.021

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Abstract

Background and Aims: Though Noradrenaline infusion is showing promising results for management of spinal anaesthesia-induced hypotension, there are very few studies that evaluated intermittent intravenous (i.v) bolus dose of inj. Noradrenaline. So, we aimed to compare intermittent i.v. bolus of phenylephrine and noradrenaline in management of spinal anaesthesia-induced hypotension in elective LSCS.
Materials and Methods: This randomized controlled study was conducted in obstetrics operation theatre from August 2022 to April 2023. Intermittent I.V. bolus dose of Phenylephrine (Group A) was compared with intermittent I.V. bolus dose of Noradrenaline (Group B). Data regarding baseline heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP), hypotension, bradycardia, total number of bolus doses of study drugs required, intraoperative nausea and vomiting, neonatal Apgar score at one and 5minute, and umbilical cord blood gas analysis at birth were collected and analyzed using standard statistical tests.
Results: HR at 9 minute, 12 minutes, 15 minutes, and 20 minutes after spinal anaesthesia was significantly lower in group A than in group B. No statistically significant difference was found between the groups in terms of SBP, DBP, MAP, APGAR score at one and five minutes, UA pH, UA PO2, UA PCO2, UA HCO, UV pH, UV PO2, UV PCO2, UV HCO. Incidence of nausea and vomiting was higher in group A than in group B (P-value = 0.006).
Conclusion: Though intermittent I.V. bolus of both Phenylephrine and Noradrenaline are equally efficacious in management of spinal anaesthesia-induced hypotension during elective LSCS, inj. Noradrenaline is a better option with fewer adverse effects.
 

Keywords : Intermittent, Intravenous bolus, Phenylephrine, Noradrenaline, Spinal Anaesthesia, Hypotension, Elective caesarean section.

How to cite : Das S, Roy S, Hembrom B P M, Bhattacharya D, Choudhury A, Comparison of intermittent intravenous bolus of phenylephrine and noradrenaline in management of spinal anesthesia induced hypotension in elective cesarean section: A randomized controlled trial. Indian J Clin Anaesth 2025;12(1):139-144

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