Norepinephrine versus ephedrine to maintain arterial blood pressure during spinal anaesthesia for cesarean delivery

After the institutional ethics committee approved, after checking fasting status, informed consent and pac,I’ve access will be procedured. The baseline parameter, heart  rate ,oxygen saturation  ecg and arterial blood pressure will be recorded. Patient will be positioned in  sitting position, under all asceptic precautions Ths patient will be painted with providine iodine solution . then selected site will be draped with sterilized hole towel . Intervertebral space between L4-L5/L3-L4 intervertebral  space will be identified . A 25 G spinal needle is inserted on marked area after confirming free flow of clear CSF drug 12.5 milligrams of hyperbaric  bupivacaine 0.5% was injected and patient will be immediately placing supine position.

In group A prophylactic bolus of Norepinephrine 5mcg at time of intrathecal block plus rescue bolus of 5mcg Norepinephrine ,whenever maternal systolic blood pressure dropped by 20% of baseline value.

In group B prophylactic bolus of ephedrine 10mg at time of intrathecal block  plus rescue of 10mg ephedrine, whenever maternal systolic blood pressure dropped 20% of baseline value. Intra operative period ,blood pressure ( SBP, DBP,  MAP),Heart rate oxygen saturation noted at every 2 minutes till delivery of fetus and every 5 minutes delivery.

Neonatal outcome was assessed by APGAR score at first minut and five minut.