Perbandingan Pemberian Profilaksis Antara Phenylephrine dan Efedrin terhadap Hemodinamik Maternal dan Efeknya pada AGDA dan APGAR Skor Bayi

Abstract

Introduction: Spinal anesthesia can lead to hypotension in pregnant women. Phenylephrine is the current standard choice for managing hypotension during spinal anesthesia in patients undergoing cesarean section as it does not affect the fetus. The use of ephedrine or phenylephrine can impact parameters such as umbilical artery blood pH, APGAR scores, and arterial blood gas analysis, with evidence favoring phenylephrine. However, further research is needed to understand the effects of these two vasopressors, especially in cases of acute fetal distress. This study aimed to compare ephedrine and phenylephrine in preventing hypotension during spinal anesthesia for cesarean section and their impact on AGD and APGAR scores in newborns. Objective: This study aimed to analyze the comparison of phenylephrine and ephedrine as prophylaxis in maintaining maternal hemodynamics and their effects on arterial blood gas analysis and APGAR scores in babies after cesarean section with spinal anesthesia. Methods: This study used a double-blind randomized clinical trial comparing two research groups. The sample consisted of 38 participants, divided into two groups, with 19 receiving ephedrine and 19 receiving phenylephrine. Patients with fetal distress, contraindications to spinal anesthesia, pre-existing hemodynamic disorders before cesarean section, preeclampsia/eclampsia, and patients with BMI < 18 kg/m2 and > 30 kg/m2 were excluded from the study. Results: There was no significant difference between the effects of ephedrine and phenylephrine on systolic blood pressure and mean arterial pressure in the patient groups receiving these drugs (p>0.05). However, there was a significant difference in diastolic blood pressure and heart rate between the two groups (p<0.05). Furthermore, APGAR scores at 0 and 5 minutes in both the phenylephrine and ephedrine groups were significantly different (p<0.05), indicating significant changes in APGAR scores in both groups. There was no significant difference in AGDA between the phenylephrine and ephedrine groups (p>0.05). However, these results should be confirmed by larger and more controlled studies. Conclusion: Phenylephrine and ephedrine are equally effective in maintaining maternal hemodynamics but are superior in terms of APGAR scores and AGDA when compared to ephedrine.