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February 1, 2017Journal of the Bangladesh Society of AnaesthesiologistsOpen Access

Ephedrine and phenylephrine were equally effective in preventing and treating hypotension during spinal anaesthesia for caesarean section, with no significant differences in fetal outcomes.

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Why the study?

Does ephedrine compared to phenylephrine prevent hypotension and improve fetal outcomes in pregnant women undergoing caesarean section under spinal anaesthesia?

Population

100 patients of ASA Grade I undergoing caesarean section under spinal anaesthesia with a normal singleton…

Comparison

Prophylactic bolus dose of ephedrine 10 mg IV at… vs Prophylactic bolus dose of phenylephrine 100 µg…

Design

RCT, randomly allocated into two groups of 50 each

Follow-up

until end of surgery

Key result

Ephedrine and phenylephrine were equally effective in preventing and treating hypotension during spinal anaesthesia for caesarean section, with no significant differences in fetal outcomes.

Authors

MHM M HaqueMAMohammad Abdul AleemPHPervez Altaf Hossain

Discussion

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Overview

Bolus phenylephrine and ephedrine appear comparable for spinal hypotension in cesarean delivery; leaves open optimal agent selection pending larger trials.

Study Design

Type

RCT (n=100)

Randomization

Randomly allocated

Multicenter

No

Structured PICO

Does ephedrine compared to phenylephrine prevent hypotension and improve fetal outcomes in pregnant women undergoing caesarean section under spinal anaesthesia?

P
Population
100 ASA Grade I pregnant women with a normal singleton pregnancy beyond 37 weeks gestation undergoing caesarean section under spinal anaesthesia.
I
Intervention
Prophylactic bolus dose of ephedrine 10 mg IV at the time of intrathecal block with rescue boluses of 5 mg whenever maternal systolic blood pressure was less than 90 mmHg.
C
Comparator
Prophylactic bolus dose of phenylephrine 100 µg IV at the time of intrathecal block with rescue boluses of 50 µg whenever maternal systolic blood pressure was less than 90 mmHg.
O
Outcome
Prevention and treatment of hypotension and fetal outcome in terms of Apgar score.surrogate

Main Result

p-value: p=not significant

Ephedrine and phenylephrine are equally effective for managing hypotension during spinal anesthesia for cesarean section, with comparable neonatal outcomes.

Cite This Study

Haque et al. (2017) conducted an RCT in Hypotension during spinal anaesthesia for caesarean section (n=100). Ephedrine vs. Phenylephrine (100 µg IV prophylactic bolus, 50 µg rescue boluses) was evaluated on Prevention and treatment of hypotension (p=not significant). Ephedrine and phenylephrine were equally effective in preventing and treating hypotension during spinal anaesthesia for caesarean section, with no significant differences in fetal outcomes.

synapsesocial.com/papers/6a98079ebf4318b353fa9347https://doi.org/10.3329/jbsa.v30i1.65841
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Also Consider

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

  1. 1Randomised double‐blinded comparison of phenylephrine vs ephedrine for maintaining blood pressure during spinal anaesthesia for non‐elective Caesarean section*2008 · 127 citations
  2. 2Caesarean delivery vasopressor management2012 · 47 citations
  3. 3Comparison of Metaraminol and Ephedrine Infusions for Maintaining Arterial Pressure during Spinal Anesthesia for Elective Cesarean Section2001 · 159 citations
  4. 4Techniques for preventing hypotension during spinal anaesthesia for caesarean section2020 · 148 citations
  5. 5Obstetric Anesthesia Controversies: Vasopressor Choice for Postspinal Hypotension During Cesarean Delivery2007 · 98 citations