Background

Hypotension during subarachnoid block for caesarean section is common and can be harmful to both mother and the foetus. Treatment of such hypotension involves the use of intravenous fluids and vasopressors. Ephedrine has commonly been regarded as a vasopressor of choice in obstetrics but this traditional teaching has been challenged recently by authors and currently some authors have recommended phenylephrine as the vasopressor of choice in pregnancy.

Objective:

To compare the incidence of hypotension in pregnant women who received ephedrine or phenylephrine for prevention and treatment of maternal hypotension following subarachnoid block for caesarean section.

Methods:

This was a prospective randomized double-blind trial of 62 pregnant women who underwent elective caesarean section under subarachnoid block. Patients were divided into 2 groups (n=31 each), Group E and Group P. Group E received ephedrine infusion while group P received phenylephrine infusion. Vital signs (blood pressure, heart rate, and peripheral arterial oxygen saturation) were recorded throughout the surgery.

Results:

There was no difference in the overall maternal haemodynamic profile in both groups and the neonatal outcomes were similar. The incidence of hypotension in the ephedrine and phenylephrine groups were 6.7% and 3.2 % respectively with an overall incidence of 8.1%.

Conclusion:

Although phenylephrine showed more stable maternal haemodynamic profile around the baseline, both ephedrine and phenylephrine were equally effective and thus good options in the management of hypotension in pregnant women during caesarean section under subarachnoid block.