Abstract
Maternal hypotension is a common complication following spinal anesthesia for cesarean delivery and is associated with adverse maternal and fetal outcomes. Phenylephrine is widely used to prevent and treat this hypotension. While intermittent bolus dosing has been traditionally employed, recent research suggests that continuous phenylephrine infusion may provide better hemodynamic stability. This study aimed to compare the effectiveness of phenylephrine infusion versus bolus doses in preventing maternal hypotension during spinal anesthesia for cesarean section. In this prospective, randomized comparative study, patients undergoing elective cesarean delivery under spinal anesthesia were allocated into two groups. Group I received a prophylactic phenylephrine infusion, while Group B received phenylephrine bolus doses for the treatment of hypotension. Maternal blood pressure and heart rate were monitored at regular intervals. The primary outcome was the incidence of maternal hypotension. Secondary outcomes included total phenylephrine consumption, incidence of bradycardia, reactive hypertension, and neonatal Apgar scores. The incidence of maternal hypotension was significantly lower in the infusion group compared to the bolus group. Patients receiving phenylephrine infusion demonstrated more stable systolic blood pressure with fewer episodes of hypotension and less need for rescue vasopressor doses. Although mild bradycardia was more frequent in the infusion group, it might or might be not clinically significant. Neonatal outcomes, including Apgar scores, were comparable between both groups.