COMPARATIVE STUDY BETWEEN DIFFERENT DOSE REGIMEN OF NOREPINEPHRINE IN THE MANAGEMENT OF SPINAL HYPOTENSION IN PARTURIENTS UNDERGOING CAESAREAN SECTION

Abstract

INRODUCTION: Spinal anesthesia is increasingly becoming popular over general anesthesia due to several advantages. Spinal anesthesia provides a profound analgesic effect, less blood loss during surgery, hemodynamic stability, and beneficial surgical conditions. AIM: To compare the efficacy of low dose norepinephrine infusion with low dose boluses of norepinephrine in managing hypotension among parturients undergoing caesarean section under sub arachnoid block. MATERIALS AND METHODS: In this Randomized Double-Blind Clinical Study, patients undergoing Elective Caesarean section was divided into 3 groups, Group A- Parturient received Norepinephrine infusion of 1mcg/min and rescue bolus of 3mcg to treat hypotension. Group B- Parturient received Norepinephrine bolus of 3mcg to treat hypotension. Group C- Parturient received Norepinephrine bolus of 5mcg to treat hypotension. All the vitals at different time intervals, number of norepinephrine boluses, the total amount of norepinephrine consumed, maximum sensory level achieved, time for baby extraction following subarachnoid block and any adverse events were documented XVI RESULTS: There was no statistical difference noted in the demographics of the study groups. There was a significant difference in mean systolic blood pressure between the groups from skin incision to baby extraction at T6 and T8. The mean arterial blood pressure of the two groups differed significantly throughout the period from baby extraction to skin suturing. Between the groups, there was a substantial difference in the total number of boluses needed. The total number of boluses required was maximum in group B followed by group C. Group A required the minimum number of total norepinephrine boluses. CONCLUSION: A prophylactic Norepinephrine infusion is an effective and simple method of reducing the incidence and magnitude of hypotension during spinal anesthesia for cesarean delivery with no adverse effect.