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September 1, 2001Anesthesiology

Phenylephrine Added to Prophylactic Ephedrine Infusion during Spinal Anesthesia for Elective Cesarean Section

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Why the study?

Does adding phenylephrine to an ephedrine infusion prevent spinal hypotension in parturients undergoing elective cesarean section?

Population

39 parturients with American Society of Anesthesiologists physical status I-II scheduled for elective…

Comparison

Ephedrine 2 mg/min plus phenylephrine 10… vs Ephedrine 2 mg/min alone infusion started…

Design

RCT, assigned randomly, double-blind fashion

Follow-up

during cesarean delivery

Authors

FMF.J. MercierUniversité Paris-SaclayEREdward T. RileyStanford MedicineWFWillard L. FredericksonHôpital Antoine-Béclère

Discussion

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Overview

Supports combined ephedrine-phenylephrine infusion to reduce spinal hypotension in cesarean delivery; confirms additive benefit over ephedrine alone in obstetric anesthesia.

Structured PICO

Does adding phenylephrine to an ephedrine infusion prevent spinal hypotension in parturients undergoing elective cesarean section?

P
Population
39 parturients with American Society of Anesthesiologists physical status I-II scheduled for elective cesarean delivery
I
Intervention
Ephedrine 2 mg/min plus phenylephrine 10 microg/min infusion started immediately after spinal injection
C
Comparator
Ephedrine 2 mg/min alone infusion started immediately after spinal injection
O
Outcome
Incidence of hypotension (defined as systolic blood pressure less than 100 mmHg and less than 80% of baseline)surrogate

Adding phenylephrine to an ephedrine infusion significantly reduces the incidence of hypotension and improves umbilical cord pH during spinal anesthesia for cesarean delivery.

Cite This Study

Mercier et al. (2001) studied this question.

synapsesocial.com/papers/6a88435f8dfe8b7ec5a54076https://doi.org/10.1097/00000542-200109000-00020
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Also Consider

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

  1. 1Comparison of Maternal and Fetal Effects of Ephedrine and Phenylephrine Infusion during Spinal Anesthesia for Cesarean Section2006 · 11 citations
  2. 2Comparing Intravenous Phenylephrine and Ephedrine for Hypotension During Spinal Anesthesia for Elective Cesarean Section: A Randomized Double-Blind Clinical Trial2017 · 5 citations
  3. 3Comparative Study Among Ephedrine, Norepinephrine and Phenylephrine Infusions to Prevent Spinal Hypotension During Cesarean Section. A Randomized Controlled Double-Blind Study2021 · 19 citations
  4. 4A comparative study of infusions of phenylephrine, ephedrine and phenylephrine plus ephedrine on maternal haemodynamics in elective caesarean section2011 · 32 citations
  5. 5Hemodynamic outcomes of phenylephrine versus ephedrine in spinal anesthesia for cesarean section: A prospective randomized study2023