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- Title
Randomized Double Blind Comparison of Phenylephrine and Norepinephrine Boluses for Treatment of Post-Spinal Hypotension During Elective Caesarean Section.
- Authors
Sharma, Venus; Wagh, Pooja; Sharma, Pradeep
- Abstract
Background Research comparing the efficacy of phenylephrine and norepinephrine in managing post spinal hypotension among pregnant patients is limited. Objective To assess the effectiveness of phenylephrine and norepinephrine bolus doses in treating hypotension during elective cesarean section under spinal anesthesia in pregnant females hypothesizing similar neonatal outcomes. Materials and Methods: The present randomized controlled study is a single-centre, tertiary care hospital based study conducted on 90 pregnant women with singleton pregnancies experiencing postspinal hypotension during cesarean section. Patients received intravenous phenylephrine (50 µg) or norepinephrine (4 µg) for hypotension treatment, defined as = 20% drop in baseline systolic BP or absolute value < 100 mmHg. Primary outcome measure was umbilical artery pH while secondary measures were Apgar scores, hypotensive episodes, vasopressor requirements, cardiac complications, maternal outcomes. Results: Umbilical artery pH did not differ between phenylephrine and norepinephrine groups (8.26 ± 0.06 vs. 8.27 ± 0.06, respectively; P = 0.93). Median hypotensive episodes were higher with norepinephrine (2[1to3] vs.1 [1to2], P=0.014). Apgarscores, va so press ordoses, BP trends, and maternal complications were similar. Phenylephrine group had lower heart rates (P = 0.026); one had bradycardia (HR < 50 bpm) vs. none with norepinephrine (P = 1.000). Conclusions In pregnant women undergoing elective cesarean section, phenylephrine (50 µg) and norepinephrine (4 µg) bolus doses for spinal anesthesia-induced hypotension are equally effective with similar neonatal and maternal outcomes.
- Subjects
CESAREAN section; PHENYLEPHRINE; NORADRENALINE; PREGNANT women; HYPOTENSION; VAGINAL birth after cesarean
- Publication
European Journal of Cardiovascular Medicine, 2024, Vol 14, Issue 2, p999
- ISSN
2042-4884
- Publication type
Article