Perbandingan Efektivitas Phenylephrine Dosis 50μg, 75μg, 100μg sebagai Pencegahan Spinal Anesthesia-Induced Hypotension (SAIH) pada Pasien Seksio Sesarea

Abstract

Background: Spinal Anesthesia-Induced Hypotension (SAIH) is a physiological response during cesarean section under spinal anesthesia contributing to nausea, vomiting, dizziness, and even cardiovascular collapse in Moms. Phenylephrine is an α- adrenergic receptor agonist has been associated with nadi slowing and even a dosedependent decrease in cardiac output. The current standard to avoid maternal hypotension and blood pressure variability is to provide a continuous infusion of phenylephrine to limit changes from baseline. Objective: To analyze the comparative effectiveness of various doses of phenylephrine 50μg, 75μg, 100μg on the prevention of SAIH in cesarean section patients at H. Adam Malik General Hospital, Hajj General Hospital Medan, Pirngadi Hospital Medan and Rumkit Tk-II Putri Hijau Medan. Methods: This study used Randomized Clinical Trial design with double blind. Samples were divided based on phenylephrine dose: group 1 (50μg), group 2 (75μg), and group 3 (100μg). Data will be analyzed by Annova test or Kruskal Wallis test. Post hoc test was then conducted to see the difference between groups. Results: There were 47 samples with a distribution of 16 samples of group 1, 16 samples of group 2, and 15 samples of group 3. In the analysis of variables of age, height, weight, and BMI, it was found that there were no statistically significant differences between treatment groups (p=0.950, p=0.468, p=0.763, and p=0.647). It was found that systolic and diastolic blood pressure data had significant differences in T1 (p=0.020 and p=0.004) and T2 (p=0.018 and p=0.046) measurements. It was found that MAP data had significant differences in measurements T1 (p=0.004), T2 (p=0.046), and T6 (0.035). It was found that nadi data at measurement T5 (p=0.017) had a significant difference. Conclusion: The most effective dose of phenylephrine in preventing SAIH was 75μg, then 50μg, and 100μg. Although clinically all doses were considered effective in preventing SAIH.