Key result
Phenylephrine resulted in less nausea or vomiting (3.9% vs 12.7%, p=0.02) and lower umbilical arterial lactate (2.4 vs 2.6 mmol/L, p=0.002) compared to ephedrine during non-elective Caesarean section.
Why the study?
Does phenylephrine improve umbilical cord blood gases or clinical outcomes compared to ephedrine in patients with hypotension during spinal anaesthesia for non-elective Caesarean section?
Population
204 patients having non-elective Caesarean section under spinal anaesthesia with hypotension
Comparison
Boluses of phenylephrine 100 microg vs Boluses of ephedrine 10 mg
Design
RCT, randomised, double-blinded
Authors
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Phenylephrine is preferable to ephedrine for spinal hypotension in non-elective Caesarean sections; extends RCT evidence to urgent deliveries.
RCT (n=204)
Double-blind
Does phenylephrine improve umbilical cord blood gases or clinical outcomes compared to ephedrine in patients with hypotension during spinal anaesthesia for non-elective Caesarean section?
Absolute Event Rate: 3.9% vs 12.7%
p-value: p=0.02
Phenylephrine and ephedrine are both suitable vasopressors for treating hypotension during spinal anaesthesia for non-elective Caesarean section, though phenylephrine is associated with less nausea and vomiting and lower fetal lactate.
Kee et al. (2008) conducted an RCT in Hypotension during spinal anaesthesia for non-elective Caesarean section (n=204). Phenylephrine vs. Ephedrine 10 mg boluses was evaluated on Nausea or vomiting (p=0.02). Phenylephrine resulted in less nausea or vomiting (3.9% vs 12.7%, p=0.02) and lower umbilical arterial lactate (2.4 vs 2.6 mmol/L, p=0.002) compared to ephedrine during non-elective Caesarean section.
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