Hypotension is a common clinical problem of spinal anesthesia for cesarean section. Phenylephrine is a common vasopressor used in this situation. Phenylephrine reduces maternal cardiac output and heart rate but stroke volume is well maintained. Glycopyrrolate is safe for fetus and increases maternal heart rate. In this study we compared maternal hemodynamic changes between two groups,one receiving only phenylephrine infusion(group P) and another glycopyrrolate pretreatment before phenylephrine infusion(group PG)

In this study 76 women scheduled for cesarean section were allocated in two group. Group P(n=38) received phenylephrine infusion at 50 microgram/min after giving spinal anesthesia. Group PG received glycopyrrolate(0.2 mg) pretreatment before phenylephrine infusion at 50 microgram/min. phenylephrine infusion was stopped when blood pressure exceeds baseline value. A bolus of 100 microgram phenylephrine were given when blood pressure is less than 80% of baseline. Blood pressure is measured continually at 3 minute interval for 15 minutes. Heart rate, Spo2, and ECG were measured continuously.

No significant difference found in mean arterial pressure among both the groups. Heart rate decreases significantly(P<0.05) in group P. while no significant decrease in heart rate was found in group PG.

Glycopyrrolate pretreatment before phenylephrine infusion to prevent hypotension by spinal anesthesia for cesarean delivery is effective to maintain heart rate.