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Volume 13 Issue 4 (April) 2024

Original Articles

Effect of prophylactic Glycopyrrolate on the maternal hemodynamics and vasopressor requirement during spinal anesthesia for caesarean delivery
Dr. Sushma K., Dr. Mansoor Ali Savadathi, Dr. Prameela V.S., Dr. Amod Kattani Shyamprasad, Dr. Premalatha S., Dr. Kodandaram N. S., Dr T. N. Srikantamurthy

Background and Aims: Spinal anesthesia is a popular technique for caesarean delivery. The occurrence of hypotension and bradycardia induced by spinal anesthesia in parturients undergoing caesarean section can pose risks to both the fetus and the mother. Administering vasopressors prophylactically can mitigate hypotension and bradycardia, thus preserving uteroplacental blood flow.The aim of the study is to determine if Glycopyrrolate reduces the incidence of hypotension and total vasopressor dose required during elective caesarean delivery under spinal anaesthesia. Materials & Methods: 60 parturients scheduled for elective LSCS under spinal anaesthesia were randomly allocated into 2 groups of 30 each, Group G received iv Glycopyrrolate 0.2mg (1ml) and Group S received iv Saline (1ml), 5mins before subarachnoid block. The primary outcome like total amount of Ephedrine used to maintain blood pressure intra-operatively and secondary outcomes like maternal hypotension, bradycardia, tachycardia, intra-operative nausea and vomiting, dryness of mouth were also recorded. Results: 11 out of 30 parturients (36%) developed hypotension in group G whereas 23 out of 30 parturients (76%) developed hypotension in group S ( p= 0.001). Tachycardia occurred in 20% (Group G) and 23% (Group S), whereas there was Bradycardia in 3.33% in Group S and nil in Group G. The median dose of vasopressor requirement was 5mg in Group S and nil in Group G. Significant dryness of mouth was noted in group G ( p= 0.002). Conclusion: Prophylactic intravenous Glycopyrrolate in spinal anesthesia for caesarean section reduces the incidence and severity of hypotension and the need for vasopressor.

 
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