Authors : Sagar Harishchandra Pawar, Vijaykumar T Kallyanappagol, Santoshkumar Alalamath
DOI : 10.7860/jcdr/2026/87752.23394
Volume : 20
Issue : 5
Year : 2026
Page No : UC32 - UC36
Introduction: Propofol is commonly used intravenous induction agent which are frequently complicated by peri-induction hypotension. Reduced Mean Arterial Pressure (MAP) during anaesthesia contributes to significant postoperative morbidity, including renal and myocardial injury. Preventive strategies aimed at maintaining haemodynamic stability during this critical period are of clinical value. Phenylephrine offers a simple, rapid option for counteracting propofol-induced vasodilatation. Aim: To assess effectiveness of i.v. phenylephrine in preventing propofol-induced hypotension during induction of general anaesthesia. Materials and Methods: This randomised clinical trial was conducted from October 2024-December 2025 at Department of Anaesthesiology, Shri BM Patil Medical College, Hospital and Research Centre, BLDE DU, Vijayapura, Karnataka, India. The study included 130 American Society of Anaesthesiologists (ASA) I–II patients (18–65 years) undergoing elective general anaesthesia and were randomised (1:1) to receive i.v. phenylephrine 100 µg or saline before propofol induction. Primary outcome was hypotension (≥20% MAP fall). Secondary outcomes included Systolic Blood Pressure (SBP), Diastolic Blood Pressure (DBP), MAP, and Heart Rate (HR) at 5, 10, and 15 minutes. Analysed using Statistical Package for the Social Sciences (SPSS) version 20.0, normally distributed continuous variables (Shapiro-Wilk test) were expressed as mean±SD and evaluated via independent student’s t-tests. Results: The control group’s average age was 37.76±15.69 years (50.8% female, 49.2% male), the study group averaged 34.38±14.30 years (49.2% female, 50.8% male). Postinduction hypotension was lower in the study group (32.3%, n=21 vs 73.8%, n=48; p-value <0.001). At 5, 10, and 15 minutes, Group A maintained higher MAP, SBP, and DBP than Group B (all p-value <0.001), Group A vs Group B MAP was 87.88±8.694 vs 79.45±9.384 (p-value <0.001), 86.51±9.045 vs 74.86±9.890 (p-value <0.001), and 87.60±9.375 vs 77.55±8.816 mmHg (p-value <0.001); SBP was 117.80±10.145 vs 107.48±11.172 (p-value <0.001), 116.46±10.827 vs 102.37±11.870 (p-value <0.001), and 117.43±11.243 vs 105.25±10.070 mmHg (p-value <0.001); DBP was 71.45±9.038 vs 65.18±9.084 (p-value <0.001), 70.20±9.00 vs 60.98±8.977 (p-value <0.001), and 71.32±9.059 vs 63.45±8.646 mmHg (p-value <0.001). Group A HR was lower at 10 minutes (88.60±11.900 vs 93.29±14.021 bpm, p-value=0.009) and 15 minutes (85.18±11.144 vs 91.75±12.668 bpm, p-value=0.001). Conclusion: A single 100 µg bolus of phenylephrine administered immediately before induction with propofol effectively attenuated peri-induction hypotension and maintained stable haemodynamic. This simple intervention improves perioperative safety in patients at risk of hypotension.