Key result
Noradrenaline significantly delayed the onset of spinal anesthesia-induced hypotension compared to ephedrine (19.90 vs 12.53 minutes, p=0.001) during cesarean section.
Why the study?
Spinal anesthesia during cesarean section causes sympathetic block-induced hypotension, prompting comparison of prophylactic noradrenaline versus ephedrine for its management.
Does prophylactic noradrenaline delay the occurrence of hypotension compared to ephedrine in parturients undergoing cesarean section under spinal anesthesia?
Cross-Sectional (n=204)
Open-label
Non-randomized
No
Does prophylactic noradrenaline delay the occurrence of hypotension compared to ephedrine in parturients undergoing cesarean section under spinal anesthesia?
Absolute Event Rate: 19.9% vs 12.53%
p-value: p=0.001
Prophylactic noradrenaline significantly delays the onset of hypotension and reduces tachycardia compared to ephedrine during spinal anesthesia for cesarean section.
Noradrenaline may offer advantages over ephedrine for SA hypotension in caesarean delivery; hypothesis-generating and requires RCT confirmation.
Background: Spinal anesthesia (SA) is a preferred anesthetic technique for childbirth through caesarean section. It causes a sympathetic block responsible for low blood pressure which can be prevented or treated with vasopressors. Aim: This research aims to compare the effect of Noradrenaline with that of Ephedrine in the management of arterial hypotension caused by SA during Caesarean act. Study method: It was a cross-sectional study with two comparative settings which took place at the Teaching hospital of Parakou from April 15th to August 15th 2020. It included all parturients who underwent a caesarian act and received spinal anesthesia. To prevent hypotension two groups were formed. The first group parturient received Noradrenaline (10 γ) as prophylactic and the second group received Ephedrine (10 mg) before anesthesia. The main evaluation criteria were the time before the hypotension occurs and, the secondary endpoint was the number of hypotension episode. The two groups were compared using the usual statistical tests. The study received the approval of the Local Ethical committee of University of Parakou. Results: Two hundred and four parturients were compiled with 102 in each group. The mean age was 28.37 ± 6.15 years with extremes of 16 and 45 years. The main indications for Caesarean section were respectively iterative Caesarean section (46.57%) for scheduled Caesarean section and acute fetal distress (15.69%) for emergency Caesarean section. The incidence of hypotension was 38.24%. The mean delay of occurrence of hypotension was significantly longer in adrenaline group (19.90 min) than ephedrine group (12.53 min) with P = 0.001. According to the secondary endpoint the number of episodes of hypotension, number of tachycardia, and the total doses of each vasopressor were significantly lower in adrenaline group than in the ephedrine group. Conclusion: The use of Noradrenaline according to the established protocol demonstrated its efficiency compared with Ephedrine in the management of hypotension after spinal anesthesia.
No takes yet. Share an insight, caveat, or question.
Tchaou et al. (2022) conducted a cross-sectional in Arterial hypotension induced by spinal anesthesia (n=204). Noradrenaline vs. Ephedrine (10 mg prophylactic bolus plus 10 mg rescue boluses) was evaluated on Time to onset of hypotension (p=0.001). Noradrenaline significantly delayed the onset of spinal anesthesia-induced hypotension compared to ephedrine (19.90 vs 12.53 minutes, p=0.001) during cesarean section.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: