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What is the preferred vasopressor for counteracting hypotension after neuraxial anesthesia in obstetrics?
What is the preferred vasopressor for counteracting hypotension after neuraxial anesthesia in obstetrics?
Phenylephrine is currently the preferred vasopressor for treating hypotension during obstetric neuraxial anesthesia due to its favorable fetal acid-base profile.
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Supports phenylephrine preference in obstetric neuraxial anesthesia; leaves open need for direct RCTs on neonatal outcomes.
Vasopressors are routinely used to counteract hypotension after neuraxial anesthesia in Obstetrics. The understanding of the mechanism of hypotension and the choice of vasopressor has evolved over the years to a point where phenylephrine has become the preferred vasopressor. Due to the absence of definitive evidence showing absolute clinical benefit of one over the other, especially in emergency and high-risk Cesarean sections, our choice of phenylephrine over the other vasopressors like mephentermine, metaraminol, and ephedrine is guided by indirect evidence on fetal acid-base status. This review article evaluates the present day evidence on the various vasopressors used in obstetric anesthesia today.
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Deb Sanjay Nag (2015) studied this question.
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