DOI: https://doi.org/10.36347/sjams.2025.v13i06.004

Pages: 1257-1263

Background: Spinal hypotension during cesarean section is a common complication which must be adequately managed to ensure maternal and fetal safety. Vasopressor drugs like ephedrine and norepinephrine are used to augment maternal blood pressure, but their comparative effects on maternal hemodynamics and fetal outcome are yet to be completely assessed. Objective: To assess the effectiveness and safety of ephedrine and norepinephrine in augmenting maternal blood pressure and fetal status during elective cesarean section under spinal anesthesia. Method: A six-month (February 2 to August 1, 2017) double-blind comparative study was carried out at the Department of Anaesthesiology and ICU, Dhaka Medical College Hospital (DMCH), Dhaka. A total of 120 ASA I–II parturients scheduled for elective cesarean section under spinal anesthesia were randomly allocated to receive intermittent intravenous bolus of norepinephrine or ephedrine for hypotension. Maternal hemodynamics and neonatal Apgar scores were obtained and compared. Result: Norepinephrine sustained maternal blood pressure with less frequent tachycardia than with ephedrine. Although in the norepinephrine group fewer vasopressor boluses were given, such a difference was not statistically significant. No significant group difference in neonatal Apgar scores was observed. Conclusion: Norepinephrine is an effective and safe alternative to ephedrine for control of spinal anesthesia-induced hypotension during cesarean delivery without compromising neonatal outcome while offering superior maternal heart rate control.