[Nifedipine in preeclampsia for cesarean section]

Abstract

The patients with preeclampsia undergoing emergent cesarean section is always a challenge to an anesthesiologist, because severe hypertensive response after laryngoscopy and tracheal intubation may result in life-threatening complication such as cerebral hemorrhage. Most of these patients receive magnesium sulfate for the prevention of convulsion. An ideal anti-hypertensive drug for preeclampsia should be effective, limited fall in blood pressure, rapid onset, maintaining uteroplacental blood flow, and less maternal and fetal side effects. We studied the efficacy of 10 mg sublingual nifedipine in attenuating the pressor response to intubation. We were also concerned about whether this calcium antagonist may inhibit uterine contraction and increase intra and postpartum hemorrhage when it is used with magnesium sulfate and general anesthesia. There were thirty-three patients in our study (16 in nifedipine group and 17 in control group). This study revealed that nifedipine attenuate the hypertensive response effectively. Uterine contraction response to oxytocic drugs was quite well in both groups. There was no significant difference in blood loss between nifedipine and control group. And no severe maternal and fetal adverse effect.