Key result
The study determined the effective dose (ED90) of intermittent intravenous norepinephrine boluses to prevent post-spinal hypotension in women undergoing elective cesarean delivery.
Norepinephrine infusion shows similar efficacy with fewer side effects; leaves open its adoption as preferred alternative pending confirmatory trials.
(Anesth Analg. 2017;125(1):212–218) Phenylephrine, which is easy to titrate, is the current first-choice vasopressor for prevention and treatment of maternal hypotension during spinal anesthesia for cesarean delivery (CD). However, it has a propensity to increase afterload and reduce maternal heart rate and cardiac output. Norepinephrine has been suggested as an alternative, with a proposed potency ratio for norepinephrine to phenylephrine of 16:1, although its administration as a bolus during CD has not been established. The authors of the present study thus determined the effective norepinephrine dose (ED90), when given as intermittent intravenous boluses, to prevent post-spinal hypotension in women undergoing elective CD.
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Onwochei et al. (2018) studied maternal hypotension during spinal anesthesia for cesarean delivery. Norepinephrine was evaluated on effective norepinephrine dose (ED90) to prevent post-spinal hypotension. The study determined the effective dose (ED90) of intermittent intravenous norepinephrine boluses to prevent post-spinal hypotension in women undergoing elective cesarean delivery.
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