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March 29, 2022International Journal of Health SciencesOpen Access

Prophylactic phenylephrine (15 mcg/min) required fewer additional boluses (p<0.001) and resulted in lower neonatal acidosis (p<0.05) compared to ephedrine (1.5 mg/min) during caesarian section.

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Why the study?

Hypotension is a major complication following spinal anesthesia for caesarian delivery that requires prompt treatment to prevent maternal symptoms and fetal acidemia, making comparative evaluation of prophylactic vasopressor infusions essential.

Does prophylactic phenylephrine prevent hypotension and neonatal acidosis better than ephedrine in patients undergoing caesarian section under spinal anesthesia?

Population

Patients undergoing caesarian section under spinal anesthesia

Comparison

Prophylactic infusion of phenylephrine vs ephedrine

Key result

Prophylactic phenylephrine (15 mcg/min) required fewer additional boluses (p<0.001) and resulted in lower neonatal acidosis (p<0.05) compared to ephedrine (1.5 mg/min) during caesarian section.

Authors

HRHarekrishna RayMBMadhumita BiswalBPBasanta Kumar Pradhan

Discussion

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Member takes

Overview

Suggests phenylephrine advantage in cesarean spinal anesthesia; hypothesis-generating pending randomized confirmation.

Structured PICO

Does prophylactic phenylephrine prevent hypotension and neonatal acidosis better than ephedrine in patients undergoing caesarian section under spinal anesthesia?

P
Population
Patients undergoing elective lower segment caesarian section under spinal anesthesia receiving prophylactic vasopressor therapy.
I
Intervention
Prophylactic infusion of phenylephrine (15 mcg/min)
C
Comparator
Prophylactic infusion of ephedrine (1.5 mg/min)
O
Outcome
Maintenance of arterial blood pressure (systolic, diastolic, and mean arterial pressure) and neonatal outcome (pH value and acidosis)surrogate

Main Result

p-value: p=<0.001

Prophylactic phenylephrine is more efficacious than ephedrine in maintaining arterial blood pressure and results in less neonatal acidosis during spinal anesthesia for caesarian section.

Cite This Study

Ray et al. (2022) studied Hypotension following spinal anesthesia for caesarian delivery. Phenylephrine vs. Ephedrine 1.5 mg/min was evaluated on Requirement of additional bolus and neonatal acidosis (p=<0.001). Prophylactic phenylephrine (15 mcg/min) required fewer additional boluses (p<0.001) and resulted in lower neonatal acidosis (p<0.05) compared to ephedrine (1.5 mg/min) during caesarian section.

synapsesocial.com/papers/6a93014bd10fd8fa3bf0b275https://doi.org/10.53730/ijhs.v6ns1.5155
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Also Consider

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

  1. 1Comparison between phenylephrine and ephedrine in preventing hypotension during spinal anesthesia for cesarean section2012 · 28 citations
  2. 2Ephedrine versus Phenylephrine: Prevention of Hypotension during Spinal Anaesthesia for Cesarean Section and Effects on the Fetus2017
  3. 3A Comparative Study of Ephedrine and Phenylephrine in Averting Hypotension during Cesarean Section under Spinal Anesthesia2022
  4. 4Effects of phenylephrine and ephedrine in prevention and treatment of hypotension during spinal anaesthesia for elective cesarean section2022 · 2 citations
  5. 5A comparative study of phenylephrine and ephedrine combination to ephedrine and phenylephrine alone for maintenance of blood pressure for caesarean delivery and their effects on foetal acid base status2018 · 3 citations