Does a fixed-rate norepinephrine infusion prevent hypotension as effectively as a fixed-rate phenylephrine infusion in patients undergoing elective cesarean section under regional anesthesia?
Norepinephrine is an effective alternative to phenylephrine for managing hypotension during cesarean section, offering the advantage of avoiding bradycardia and potentially improving neonatal acid-base profiles.
A fixed-rate infusion of norepinephrine is as effective in the management of hypotension during regional anesthesia for cesarean section as a fixed-rate infusion of phenylephrine, with the avoidance of phenylephrine-induced bradycardia. The more favourable neonatal acid-base profile of noradrenaline might be due to better maintenance of placental blood flow in the noradrenaline group due to its beta action, while the higher fetal glucose concentration in the same group might result from a catecholamine-stimulated glucose metabolism increase and a β-receptor mediated insulin decrease.
Theodoraki et al. (Sat,) studied this question.
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