| ORIGINAL ARTICLE |
|
| Year : 2013 | Volume
: 6
| Issue : 3 | Page : 230-235 |
|
|
Beneficial effects of sublingual misoprostol administration before elective Cesarean section under spinal anesthesia
Ahmed M. El-Hennawy, Adel M. Fahmy
Department of Anesthesiology, Intensive Care, and Pain Managements, Faculty of Medicine, Ain-Shams University, Cairo, Egypt
Correspondence Address:
Ahmed M. El-Hennawy
MD, Department of Anesthesiology, Intensive Care, and Pain Managements, Faculty of Medicine, Ain-Shams University, Cairo
Egypt
 Source of Support: None, Conflict of Interest: None  | Check |
|
|
|
Background
Misoprostol is an inexpensive, stable, orally active prostaglandin E1 analog. Sublingual and buccal routes have been shown to reduce blood loss during Cesarean section and vasoconstrictor effects have also been observed at selected sites.
Patients and methods
Sixty ASA I and II female patients undergoing elective Cesarean section were included in this randomized, double-blind, controlled study. After application of standard monitors, proper fluid preload, and performance of spinal anesthesia, patients were randomly assigned to receive either two sublingual misoprostol tablets (400μg) (group A) or two white coated placebo tablets with a shape similar to that of the misoprostol tablets (group B). The mtraoperatively recorded parameters included vital signs, uterine tone, blood loss, fetal APGAR score, shivering, nausea, and vomiting. The postoperatively recorded parameters included vital signs, shivering, nausea, vomiting, and diarrhea.
Results
The mtraoperatively recorded parameters showed that group A patients had significantly higher mean arterial blood pressure values, significantly lower mean phenylephrine consumption (48.5 ± 7.9 vs. 1 25.1 ±11.7 (j.g), lower mean oxytocin consumption (13.7 ± 1.5 vs. 22.1 ± 3.4 III), and lower mean blood loss (489.7 ± 1 9.6 vs. 895.1 ± 24.8 ml); however, the APGAR scores were similar between both groups. The postoperatively recorded parameters showed significantly higher incidences of fever and shivering in group A compared with group B (23.3 vs. 6.66% and 43.3 vs. 23.3%, respectively).
Conclusion
Administration of sublingual misoprostol (400μg) at the beginning of elective Cesarean section under spinal anesthesia can decrease spinal-induced hypotension and phenylephrine consumption. In addition, it decreases intraoperative blood loss and oxytocin requirement with few mild side effects and no effect on the fetus. |
|
|
|
| [PDF]* |
|
 |
|
