Key result
Prophylactic metaraminol infusion was non-inferior and superior to phenylephrine for neonatal umbilical arterial pH during elective caesarean section (MD 0.03; 95% CI 0.01-0.04; p=0.0002).
Why the study?
Does metaraminol infusion improve umbilical arterial pH compared to phenylephrine in women undergoing elective caesarean section with spinal anaesthesia?
Population
185 women who underwent elective caesarean section under spinal and combined spinal-epidural anaesthesia
Comparison
Metaraminol infusion started immediately after… vs Phenylephrine infusion started immediately after…
Design
RCT, randomised, double-blind
Authors
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Metaraminol may supplant phenylephrine as first-line vasopressor in spinal anesthesia for elective cesarean delivery; extends RCT evidence for optimized neonatal outcomes.
RCT (n=185)
Double-blind
randomised
Yes
Does metaraminol infusion improve umbilical arterial pH compared to phenylephrine in women undergoing elective caesarean section with spinal anaesthesia?
Mean Difference: 0.03 (95% CI 0.01–0.04)
Absolute Event Rate: 7.31% vs 7.28%
p-value: p=0.0002
Metaraminol infusion is superior to phenylephrine for neonatal acid-base outcomes when used to prevent hypotension during spinal anesthesia for elective caesarean section.
McDonnell et al. (2017) conducted an RCT in Elective caesarean section under spinal anaesthesia (n=185). Metaraminol vs. Phenylephrine (50 μg.min−1) was evaluated on Difference in umbilical arterial pH between groups (MD 0.03, 95% CI 0.01-0.04, p=0.0002). Prophylactic metaraminol infusion was non-inferior and superior to phenylephrine for neonatal umbilical arterial pH during elective caesarean section (MD 0.03; 95% CI 0.01-0.04; p=0.0002).
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