European Journal of Cardiovascular Medicine

This randomized clinical study conducted at MKCG Medical College & Hospital aimed to assess and compare the effectiveness of prophylactic infusion of ephedrine and phenylephrine in maintaining arterial pressure during lower segment caesarean section (LSCS) under sub-arachnoid block. The study included 80 full-term pregnant patients undergoing elective LSCS, with 40 patients in each group. The primary outcomes evaluated were changes in arterial pressure, heart rate, and fetal outcomes.

The results indicated that both ephedrine and phenylephrine were effective in maintaining arterial pressure within 20% of the baseline, with phenylephrine demonstrating a better blood pressure maintenance profile. Additional bolus dose requirements were significantly higher in the ephedrine group. Phenylephrine caused a reduction in heart rate, while ephedrine resulted in a significant rise. Neonatal outcomes, as measured by Apgar scores, were comparable between the two groups, but phenylephrine was associated with less fetal acidosis than ephedrine.

In conclusion, prophylactic infusion of phenylephrine at 15 micrograms/min proved more efficacious in maintaining arterial pressure during LSCS compared to ephedrine at 1.5 mg/min. The study suggests that phenylephrine may offer advantages in terms of maternal and fetal outcomes in the context of spinal anesthesia for caesarean section.