Key result
Prophylactic phenylephrine resulted in fewer patients requiring rescue doses for hypotension (15% vs 35%) compared to ephedrine during spinal anesthesia for cesarean section, though the difference was reported as not statistically significant.
Why the study?
Spinal anaesthesia commonly causes hypotension and bradycardia with potentially deleterious maternal and fetal effects, prompting a comparison of ephedrine against phenylephrine for prevention and treatment.
Does phenylephrine prevent hypotension better than ephedrine in parturients undergoing elective cesarean section under spinal anesthesia?
Population
80 ASA I/II patients posted for elective Cesarean Section
Comparison
100ug IV phenylephrine vs 10mg IV ephedrine
Design
Prospective randomized study
Authors
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Phenylephrine may offer better hypotension control than ephedrine in elective cesarean spinal anesthesia; leaves open need for larger RCTs to guide practice.
RCT (n=80)
chit method
No
Does phenylephrine prevent hypotension better than ephedrine in parturients undergoing elective cesarean section under spinal anesthesia?
Absolute Event Rate: 15% vs 35%
p-value: p=0.7147
Phenylephrine is more effective than ephedrine for preventing and treating hypotension during spinal anesthesia for elective cesarean section, though it is associated with a higher incidence of reflex bradycardia.
Chauhan et al. (2022) conducted an RCT in Hypotension during spinal anesthesia for cesarean section (n=80). Phenylephrine vs. Ephedrine 10 mg IV prophylactic bolus was evaluated on Patients requiring rescue dose for hypotension (p=0.7147). Prophylactic phenylephrine resulted in fewer patients requiring rescue doses for hypotension (15% vs 35%) compared to ephedrine during spinal anesthesia for cesarean section, though the difference was reported as not statistically significant.
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