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June 1, 1998AnesthesiologyOpen Access

Prophylactic Angiotensin II Infusion during Spinal Anesthesia for Elective Cesarean Delivery 

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Why the study?

Does prophylactic angiotensin II infusion improve maternal hemodynamics and fetal status compared to ephedrine in women undergoing spinal anesthesia for elective cesarean delivery?

Population

54 women undergoing spinal anesthesia for elective cesarean delivery

Comparison

Prophylactic angiotensin II infusion… vs Prophylactic ephedrine infusion intravenously…

Design

RCT, randomized

Follow-up

at delivery (up to 30 minutes)

Authors

RVRobert D. VincentMontreal Neurological Institute and HospitalCWCarol F. WerhanWright State UniversityPNPatricia F. NormanJackson Memorial Hospital

Discussion

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Implication

Angiotensin II may be preferred to ephedrine for hypotension prophylaxis in cesarean spinal anesthesia; extends RCT data guiding obstetric vasopressor choice.

Structured PICO

Does prophylactic angiotensin II infusion improve maternal hemodynamics and fetal status compared to ephedrine in women undergoing spinal anesthesia for elective cesarean delivery?

P
Population
54 women undergoing spinal anesthesia for elective cesarean delivery
I
Intervention
Prophylactic angiotensin II infusion intravenously (initiated at 10 ng/kg/min, adjusted to maintain maternal systolic blood pressure at 90-100% of baseline) simultaneous with subarachnoid injection
C
Comparator
Prophylactic ephedrine infusion intravenously (initiated at 50 microg/kg/min, adjusted to maintain maternal systolic blood pressure at 90-100% of baseline) simultaneous with subarachnoid injection
O
Outcome
Maternal blood pressure and heart rate, and fetal status at delivery (umbilical arterial and venous blood pH and base excess)surrogate

Prophylactic angiotensin II during spinal anesthesia for cesarean delivery effectively maintains maternal blood pressure with a more favorable maternal heart rate and fetal acid-base profile compared to ephedrine.

Cite This Study

Vincent et al. (1998) studied this question.

synapsesocial.com/papers/6a7632c1b52b7ee7dcfbe6c7https://doi.org/10.1097/00000542-199806000-00009
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1The Vascular Mechanism of Ephedrine's Beneficial Effect on Uterine Perfusion during Pregnancy1992 · 60 citations
  2. 2The chronically instrumental ewe: a model for studying vascular reactivity to angiotensin II in pregnancy.1981 · 75 citations
  3. 3The half‐lives of angiotensin II, angiotensin II‐amide, angiotensin III, Sar1‐Ala8‐angiotensin II and renin in the circulatory system of the rat.1978 · 72 citations
  4. 4Ephedrine Remains the Vasopressor of Choice for Treatment of Hypotension during Ritodrine Infusion and Epidural Anesthesia1994 · 39 citations
  5. 5Uterine and nonuterine vascular responses to angiotensin II in ovine pregnancy1989 · 41 citations