Key result
Phenylephrine and ephedrine demonstrated similar efficacy in treating spinal-induced intra-operative hypotension during caesarean sections, with 55.4% and 51.5% of patients respectively requiring additional vasopressor therapy.
Why the study?
Does phenylephrine compared to ephedrine improve maternal hypotension and neonatal outcomes in healthy pregnant women undergoing elective caesarian delivery under spinal anesthesia?
RCT (n=202)
Double-blind
Computer-generated random number table
No
Does phenylephrine compared to ephedrine improve maternal hypotension and neonatal outcomes in healthy pregnant women undergoing elective caesarian delivery under spinal anesthesia?
Phenylephrine and ephedrine are equally effective in treating hypotension after spinal anesthesia for caesarean section, though phenylephrine is associated with a slightly better fetal acid-base status.
Answers are grounded in this paper and cite their sources.
Both agents equally effective for post-spinal hypotension in cesarean delivery; supports phenylephrine preference for better umbilical pH.
AIM: The aim of the study was to examine whether ephedrine and phenylephrine were different in their efficacy for managing maternal hypotension and their effect of adverse maternal and neonatal outcome. METHODS: A double-blind randomized controlled study in healthy pregnant women ASA physical status 2, which underwent elective caesarian delivery under spinal anesthesia. Patients were randomized to receive an intravenous bolus of either phenylephrine (Ph group) or ephedrine (E group) immediately after the episode of hypotension after spinal anesthesia. Maternal and neonatal outcomes were recorded. RESULTS: Two hundred and two (202) pregnant women at term were entered in this study. There were no differences between group E and group Ph regarding the incidence of hypotension after vasopressor therapy, and the incidence of nausea and vomiting. There was no significant difference between groups in the first-minute and the 5th minute Apgar score, none of the neonates had the true fetal acidosis. CONCLUSIONS: Ephedrine and phenylephrine have the same efficacy in treating hypotension after spinal anesthesia for caesarean section. The use of Phenylephrine was associated with better fetal acid-base status, and there were no differences on Apgar score values and on the incidence of maternal bradycardia and hypotension.
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Soxhuku-Isufi et al. (2015) conducted an RCT in Hypotension after spinal anesthesia for caesarean section (n=202). Phenylephrine vs. Ephedrine was evaluated on Incidence of persistent severe hypotension needing additional vasopressor therapy (p=0.82). Phenylephrine and ephedrine demonstrated similar efficacy in treating spinal-induced intra-operative hypotension during caesarean sections, with 55.4% and 51.5% of patients respectively requiring additional vasopressor therapy.
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