Abstract

ALEGRE ANDRADE, Patricia; MAMANI ORTIZ, Yercin  and  ARNICA GAMON, Alexander. Norepinephrine and Etilefrin as prevention of maternal hypotension in cesarean section under spinal anesthesia. Rev Cient Cienc Méd [online]. 2018, vol.21, n.1, pp.68-77. ISSN 2077-3323.

Introduction: In Bolivia there is the difficulty on availability of the drug such as phenylephrine, there is the immediate need to evaluate another drug with pharmacological characteristics that are useful for this purpose. Objetive: To compare the use of norepinephrine versus etilefrine as prevention of maternal hypotension after spinal anesthesia in elective cesarean section. Methods: Was conducted a randomized double-blind clinical trial in 126 patients undergoing Cesarean section under spinal anesthesia divided into three groups of 42 patients. Group E received Etilefrine bolus 2 mg, group NB norepinephrine bolus 5 μg and group NI norepinephrine infusion 0,01 μg /kg/min to control hypotension control of mean arterial pressure, heart rate, were performed an analysis of drug cost and scores of APGAR. Was performed the statistical analysis in SPSS 22 and Microsoft Excel 2010. Results: Mean arterial blood pressure was similar until before birth, later it is better controlled with norepinephrine infusion (p 0,000). The most stable heart rate in the NB group (p 0,000). There were maternal adverse effects and in the newborn. There is a higher cost to use bolus ethylephrine 42.5 ± 8.36 (bolivianos) than to use norepinephrine in infusion 0.50 ±0.15 (bolivianos) and bolus norepinephrine 0.45 ±0.14 (bolivianos) there is a statistically significant difference (p 0,000). Conclusions: The use of norepinephrine in infusion compared to etilefrine is effective because the hemodynamic variables were better controlled at a very low cost for the management of maternal hypotension after spinal anesthesia.

Keywords : hypotension; spinal anesthesia; vasopressors.

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