Key result
Phenylephrine significantly reduced the frequency of spinal anesthesia-induced hypotension compared to ephedrine (30.0% vs. 63.3%; p=0.010) in women undergoing elective caesarean section.
Why the study?
Does phenylephrine prevent spinal anesthesia induced hypotension better than ephedrine in women undergoing elective caesarean section?
RCT (n=60)
Single-blind
Randomly allocated
No
Does phenylephrine prevent spinal anesthesia induced hypotension better than ephedrine in women undergoing elective caesarean section?
Prophylactic intravenous phenylephrine significantly reduces the incidence of spinal anesthesia-induced hypotension compared to ephedrine in women undergoing elective caesarean section.
Answers are grounded in this paper and cite their sources.
Supports phenylephrine over ephedrine to prevent spinal hypotension in elective caesarean sections; confirms RCT superiority for vasopressor choice.
Objectives: To compare ephedrine versus phenylephrine for prevention of spinalanesthesia induced hypotension in patients undergoing elective caesarean section. Design: Itwas a randomized controlled trial. Place and Duration of Study: This study was conducted atthe Department of Anesthesia, Allied Hospital Faisalabad from July 2011 to December 2011.Material and Methods: 60 women having C-section under spinal anesthesia were includedafter written informed consent. These patients were randomly allocated into two treatmentgroups. Group-E received ephedrine 10mg intravenously and group-P received phenylephrine100μg intravenously just after institution of spinal anesthesia. Outcome variable was frequencyof spinal anesthesia induced hypotension which was noted and compared among the groups.A predesigned proforma was used to record patient’s demographic details along with otherstudy variables. Results: The mean age of the patients was 25.73±3.78 years in Group-Pand 26.07±4.32 in Group-E (p=0.37). There was significant difference in the mean heart rate(85.50±2.64 vs. 96.93±9.96 bpm; p=0.001) and mean systolic (100.77±9.77 vs. 94.00±9.28mmHg; p=0.007) and diastolic (58.53±10.09 vs. 53.03±8.78; p=0.028) blood pressure amongthe two groups (Group-P vs. Group-E) at 20 minutes after induction. The frequency of spinalanesthesia induced hypotension was significantly lower in patients receiving phenylephrine(30.0% vs. 63.3%; p=0.010) as compared to those receiving ephedrine. Similar significantdifference was observed across various age and ASA–Class groups. Conclusion: Thefrequency of hypotension was significantly lower in patients receiving phenylephrine comparedto ephedrine which advocate routine use of phenylephrine in such patients to minimize the riskof hypotension with associated morbidity.
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Maqbool et al. (2017) conducted an RCT in Spinal anesthesia-induced hypotension (n=60). Phenylephrine vs. Ephedrine 10mg intravenously was evaluated on Frequency of spinal anesthesia-induced hypotension (systolic blood pressure ≤90mmHg during the first 20 minutes) (p=0.010). Phenylephrine significantly reduced the frequency of spinal anesthesia-induced hypotension compared to ephedrine (30.0% vs. 63.3%; p=0.010) in women undergoing elective caesarean section.
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