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Evaluation of pre-emptive intramuscular phenylephrine and ephedrine for reduction of spinal anaesthesia-induced hypotension during Caesarean section.
Br J Anaesth 2001; 86(3):372-6BJ

Abstract

Pre-emptive intramuscular (i.m.) vasopressors were evaluated in 108 patients undergoing elective Caesarean section under spinal anaesthesia, assigned to four groups in a randomized, double-blind, placebo-controlled study. Group 1 received pre-emptive phenylephrine 4 mg i.m., group 2 received phenylephrine 2 mg i.m., group 3 received ephedrine 45 mg i.m., while controls received an i.m. injection of saline, all given immediately after induction of spinal anaesthesia. Hypotension was defined as a 25% decrease in mean arterial pressure (MAP). Rescue intravenous (i.v.) boluses of ephedrine were given if the patient was hypotensive or reported nausea, vomiting or dizziness. The incidence of hypotension was 33% in the phenylephrine 4 mg group compared with 70% in the control and phenylephrine 2 mg groups (P=0.03), and 48% in the ephedrine 45 mg group. The phenylephrine 4 mg and ephedrine 45 mg groups had a significantly lower percentage reduction in MAP (-21 (SD 14)% and -22 (14)%) compared with controls (-32 (18)%, P=0.04). They also had a lower total dose of rescue i.v. ephedrine (15.7 (15.7) mg and 15.8 (15.6) mg) compared with controls (28.8 (20.6) mg, P=0.02). We conclude that pre-emptive i.m. phenylephrine 4 mg and ephedrine 45 mg reduce the severity of hypotension and the total dose of rescue i.v. ephedrine during spinal anaesthesia for Caesarean section.

Authors+Show Affiliations

University Department of Anaesthesia, University Hospitals of Leicester NHS Trust, Leicester General Hospital, UK.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Comparative Study
Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

11573527

Citation

Ayorinde, B T., et al. "Evaluation of Pre-emptive Intramuscular Phenylephrine and Ephedrine for Reduction of Spinal Anaesthesia-induced Hypotension During Caesarean Section." British Journal of Anaesthesia, vol. 86, no. 3, 2001, pp. 372-6.
Ayorinde BT, Buczkowski P, Brown J, et al. Evaluation of pre-emptive intramuscular phenylephrine and ephedrine for reduction of spinal anaesthesia-induced hypotension during Caesarean section. Br J Anaesth. 2001;86(3):372-6.
Ayorinde, B. T., Buczkowski, P., Brown, J., Shah, J., & Buggy, D. J. (2001). Evaluation of pre-emptive intramuscular phenylephrine and ephedrine for reduction of spinal anaesthesia-induced hypotension during Caesarean section. British Journal of Anaesthesia, 86(3), pp. 372-6.
Ayorinde BT, et al. Evaluation of Pre-emptive Intramuscular Phenylephrine and Ephedrine for Reduction of Spinal Anaesthesia-induced Hypotension During Caesarean Section. Br J Anaesth. 2001;86(3):372-6. PubMed PMID: 11573527.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Evaluation of pre-emptive intramuscular phenylephrine and ephedrine for reduction of spinal anaesthesia-induced hypotension during Caesarean section. AU - Ayorinde,B T, AU - Buczkowski,P, AU - Brown,J, AU - Shah,J, AU - Buggy,D J, PY - 2001/9/28/pubmed PY - 2001/10/12/medline PY - 2001/9/28/entrez SP - 372 EP - 6 JF - British journal of anaesthesia JO - Br J Anaesth VL - 86 IS - 3 N2 - Pre-emptive intramuscular (i.m.) vasopressors were evaluated in 108 patients undergoing elective Caesarean section under spinal anaesthesia, assigned to four groups in a randomized, double-blind, placebo-controlled study. Group 1 received pre-emptive phenylephrine 4 mg i.m., group 2 received phenylephrine 2 mg i.m., group 3 received ephedrine 45 mg i.m., while controls received an i.m. injection of saline, all given immediately after induction of spinal anaesthesia. Hypotension was defined as a 25% decrease in mean arterial pressure (MAP). Rescue intravenous (i.v.) boluses of ephedrine were given if the patient was hypotensive or reported nausea, vomiting or dizziness. The incidence of hypotension was 33% in the phenylephrine 4 mg group compared with 70% in the control and phenylephrine 2 mg groups (P=0.03), and 48% in the ephedrine 45 mg group. The phenylephrine 4 mg and ephedrine 45 mg groups had a significantly lower percentage reduction in MAP (-21 (SD 14)% and -22 (14)%) compared with controls (-32 (18)%, P=0.04). They also had a lower total dose of rescue i.v. ephedrine (15.7 (15.7) mg and 15.8 (15.6) mg) compared with controls (28.8 (20.6) mg, P=0.02). We conclude that pre-emptive i.m. phenylephrine 4 mg and ephedrine 45 mg reduce the severity of hypotension and the total dose of rescue i.v. ephedrine during spinal anaesthesia for Caesarean section. SN - 0007-0912 UR - https://www.unboundmedicine.com/medline/citation/11573527/Evaluation_of_pre_emptive_intramuscular_phenylephrine_and_ephedrine_for_reduction_of_spinal_anaesthesia_induced_hypotension_during_Caesarean_section_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0007-0912(17)37228-8 DB - PRIME DP - Unbound Medicine ER -