Why the study?
Does a combination of ephedrine and phenylephrine improve blood pressure maintenance and foetal acid base status compared to either agent alone in parturients undergoing emergency caesarean section under spinal anaesthesia?
Population
90 parturients beyond 32 weeks of pregnancy undergoing emergency caesarean section under spinal anaesthesia
Comparison
Combination infusion of ephedrine 4 mg/ml and… vs Ephedrine infusion 8 mg/ml alone or…
Design
RCT, randomized, double blind
Follow-up
until clamping of umbilical cord
Key result
A combination of phenylephrine and ephedrine effectively managed spinal-induced hypotension with minimal side effects, whereas phenylephrine alone resulted in bradycardia in 30% of patients.
Authors
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May inform vasopressor choice for spinal hypotension in caesarean; leaves open optimal regimen pending larger trials.
RCT (n=90)
Double-blind
randomized
Does a combination of ephedrine and phenylephrine improve blood pressure maintenance and foetal acid base status compared to either agent alone in parturients undergoing emergency caesarean section under spinal anaesthesia?
A combination of phenylephrine and ephedrine effectively prevents spinal-induced hypotension during caesarean section while minimizing maternal bradycardia and foetal acidosis compared to either agent alone.
Verma et al. (2018) conducted an RCT in emergency caesarean section under spinal anaesthesia (n=90). Ephedrine and phenylephrine combination vs. Ephedrine alone (8 mg/ml) or phenylephrine alone (100 mcg/ml) was evaluated on Incidence of hypotension. A combination of phenylephrine and ephedrine effectively managed spinal-induced hypotension with minimal side effects, whereas phenylephrine alone resulted in bradycardia in 30% of patients.
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