Randomized double-blind study compares prophylactic phenylephrine administration methods in cesarean delivery, suggesting practical alternatives in low-resource settings.
( Anesth Analg . 2025;141:736-739. doi:10.1213/ANE.0000000000007511) Phenylephrine is widely regarded as the first-line vasopressor for treating hypotension following spinal anesthesia (SA) in cesarean delivery (CD). International consensus guidelines recommend administering it as a variable-rate prophylactic infusion using syringe pumps to maintain maternal systolic blood pressure (SBP) near baseline. However, in low-resource settings where infusion pumps are not always available, prophylactic bolus administration may be a practical alternative. Earlier research comparing fixed-rate infusions with boluses suggested no significant clinical advantage of infusions. Still, it used nonvariable, high-dose infusion protocols, which prompted the present study to compare prophylactic variable-rate infusion and titrated bolus regimens of phenylephrine during elective CD under SA.
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