Key result
In women with severe pre-eclampsia and spinal hypotension, phenylephrine resulted in a greater decrease in cardiac index compared to ephedrine (-12.0% vs 2.6%; P=0.0001).
Why the study?
Does phenylephrine compared to ephedrine alter the percentage change in cardiac index in women with severe pre-eclampsia experiencing spinal hypotension during caesarean section?
Population
42 women with severe early onset pre-eclampsia undergoing caesarean section, of which 20 developed…
Comparison
Phenylephrine administered for spinal hypotension vs Ephedrine administered for spinal hypotension
Design
RCT, Randomly allocated
Follow-up
150 seconds measurement period
Authors
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Greater cardiac index reduction with phenylephrine versus ephedrine warrants caution in severe pre-eclampsia; extends RCT evidence on vasopressor haemodynamics.
RCT (n=42)
Does phenylephrine compared to ephedrine alter the percentage change in cardiac index in women with severe pre-eclampsia experiencing spinal hypotension during caesarean section?
Absolute Event Rate: -12% vs 2.6%
p-value: p=0.0001
Phenylephrine effectively reverses spinal anaesthesia-induced haemodynamic changes in severe pre-eclampsia, though it results in a greater reduction in cardiac index compared to ephedrine.
Dyer et al. (2017) conducted an RCT in Severe early onset pre-eclampsia (n=42). Phenylephrine vs. Ephedrine (7.5 mg initial dose) was evaluated on Percentage change in cardiac index (p=0.0001). In women with severe pre-eclampsia and spinal hypotension, phenylephrine resulted in a greater decrease in cardiac index compared to ephedrine (-12.0% vs 2.6%; P=0.0001).
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