Key result
Prophylactic intravenous bolus of norepinephrine (6 µg) and ephedrine (10 mg) showed comparable efficacy in preventing spinal anesthesia-induced hypotension during cesarean delivery, with incidences of 74.2% and 64.5%, respectively.
Why the study?
Vasopressors are central to managing spinal anesthesia-induced hypotension during cesarean delivery, but the comparative effects of prophylactic boluses of ephedrine versus norepinephrine remained to be evaluated.
Does prophylactic norepinephrine bolus prevent spinal anesthesia-induced hypotension better than ephedrine in term pregnant women undergoing elective cesarean delivery?
RCT (n=62)
Double-blind
Computer-generated table
No
Does prophylactic norepinephrine bolus prevent spinal anesthesia-induced hypotension better than ephedrine in term pregnant women undergoing elective cesarean delivery?
Absolute Event Rate: 74.2% vs 64.5%
p-value: p=0.582
Prophylactic IV bolus of norepinephrine (6 µg) and ephedrine (10 mg) showed comparable but insufficient efficacy in preventing spinal anesthesia-induced hypotension during cesarean delivery.
Neither single-bolus agent prevents spinal hypotension adequately in cesarean delivery; challenges norepinephrine superiority at tested doses and leaves optimized regimens open.
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AKBUDAK et al. (2022) conducted an RCT in Spinal anesthesia-induced hypotension in cesarean delivery (n=62). Norepinephrine vs. Ephedrine (10 mg IV bolus) was evaluated on Incidence of hypotension (defined as systolic blood pressure below 90% of baseline value) (p=0.582). Prophylactic intravenous bolus of norepinephrine (6 µg) and ephedrine (10 mg) showed comparable efficacy in preventing spinal anesthesia-induced hypotension during cesarean delivery, with incidences of 74.2% and 64.5%, respectively.
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