Year : 2023  |  Volume : 17  |  Issue : 1  |  Page : 107-109

Refractory hypertension after phenylephrine infusion in cesarean section under subarachnoid block

Department of Anaesthesiology and Critical Care, Maulana Azad Medical College, New Delhi, India

Correspondence Address:
Vikash Bansal
Flat No 259, Mirdard Colony, MAMC Campus, New Delhi
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/sja.sja_461_22

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A 21-year-old female was scheduled to undergo elective cesarean section for breech presentation under the subarachnoid block (SAB). The pre-operative examination was unremarkable and baseline vitals were normal. Under all aseptic precautions and American society of anesthesiologists standard monitoring, SAB was administered with 2.2 ml of 0.5% hyperbaric bupivacaine. Soon after administration of SAB, prophylactic infusion of phenylephrine was started at the rate of 50 μg/min; after pre-treatment with 0.2 mg glycopyrrolate intravenous immediately after the start of the infusion, the patient complained of severe headache. Blood pressure (BP) recorded at that time was 191/102 mm of Hg. Phenylephrine infusion was stopped immediately but the BP remained high and came to within 20% of baseline value only after 9 min of discontinuing the infusion. We report this case of refractory hypertension following phenylephrine infusion in a healthy parturient undergoing elective cesarean section under SAB.

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