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Maternal and neonatal effects of bolus administration of ephedrine and phenylephrine during spinal anaesthesia for caesarean delivery: a randomised study.
Int J Obstet Anesth 2010; 19(1):24-30IJ

Abstract

BACKGROUND

Maternal haemodynamic changes and neonatal well-being following bolus administration of ephedrine and phenylephrine were compared in 60 term parturients undergoing elective caesarean delivery under spinal anaesthesia.

METHODS

In a randomised double-blind study, women received boluses of either ephedrine 6 mg (group E; n=30) or phenylephrine 100 microg (group P; n=30) whenever maternal systolic pressure was 80% of baseline.

RESULTS

Changes in systolic pressure were comparable in the two groups. There were no differences in the incidence of bradycardia (group E: 0% vs. group P: 16.7%; P>0.05), nausea (group E: 13% vs. group: P 0; P>0.05) and vomiting (group E: 3.3% vs. group P: 0; P>0.05). Umbilical artery (UA) pH (group E: 7.29 +/- 0.04 vs. group P: 7.32 +/- 0.04; P=0.01) and venous pH (group E: 7.34 +/- 0.04 vs. group P: 7.38 +/- 0.05; P=0.002) were significantly greater in group P than in group E. UA base excess was significantly less in group E (-2.83 +/- 0.94 mEq/L) than in group P (-1.61 +/- 1.04 mEq/L; P<0.001). Apgar scores at 1, 5 and 10min and neurobehavioural scores at 2-4 h, 24 h and 48 h were similar in the two groups (P>0.05).

CONCLUSIONS

Phenylephrine 100 mug and ephedrine 6 mg had similar efficacy in the treatment of maternal hypotension during spinal anaesthesia for elective caesarean delivery. Neonates in group P had significantly higher umbilical arterial pH and base excess values than those in group E, which is consistent with other studies.

Authors+Show Affiliations

Department of Anaesthesia and Intensive Care, Vardhman Mahavir Medical College and Safdarjang Hospital, New Delhi, India. drsunilprakash@gmail.comNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

19665364

Citation

Prakash, S, et al. "Maternal and Neonatal Effects of Bolus Administration of Ephedrine and Phenylephrine During Spinal Anaesthesia for Caesarean Delivery: a Randomised Study." International Journal of Obstetric Anesthesia, vol. 19, no. 1, 2010, pp. 24-30.
Prakash S, Pramanik V, Chellani H, et al. Maternal and neonatal effects of bolus administration of ephedrine and phenylephrine during spinal anaesthesia for caesarean delivery: a randomised study. Int J Obstet Anesth. 2010;19(1):24-30.
Prakash, S., Pramanik, V., Chellani, H., Salhan, S., & Gogia, A. R. (2010). Maternal and neonatal effects of bolus administration of ephedrine and phenylephrine during spinal anaesthesia for caesarean delivery: a randomised study. International Journal of Obstetric Anesthesia, 19(1), pp. 24-30. doi:10.1016/j.ijoa.2009.02.007.
Prakash S, et al. Maternal and Neonatal Effects of Bolus Administration of Ephedrine and Phenylephrine During Spinal Anaesthesia for Caesarean Delivery: a Randomised Study. Int J Obstet Anesth. 2010;19(1):24-30. PubMed PMID: 19665364.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Maternal and neonatal effects of bolus administration of ephedrine and phenylephrine during spinal anaesthesia for caesarean delivery: a randomised study. AU - Prakash,S, AU - Pramanik,V, AU - Chellani,H, AU - Salhan,S, AU - Gogia,A R, Y1 - 2009/08/07/ PY - 2009/01/28/received PY - 2009/02/10/accepted PY - 2009/8/12/entrez PY - 2009/8/12/pubmed PY - 2010/3/26/medline SP - 24 EP - 30 JF - International journal of obstetric anesthesia JO - Int J Obstet Anesth VL - 19 IS - 1 N2 - BACKGROUND: Maternal haemodynamic changes and neonatal well-being following bolus administration of ephedrine and phenylephrine were compared in 60 term parturients undergoing elective caesarean delivery under spinal anaesthesia. METHODS: In a randomised double-blind study, women received boluses of either ephedrine 6 mg (group E; n=30) or phenylephrine 100 microg (group P; n=30) whenever maternal systolic pressure was 80% of baseline. RESULTS: Changes in systolic pressure were comparable in the two groups. There were no differences in the incidence of bradycardia (group E: 0% vs. group P: 16.7%; P>0.05), nausea (group E: 13% vs. group: P 0; P>0.05) and vomiting (group E: 3.3% vs. group P: 0; P>0.05). Umbilical artery (UA) pH (group E: 7.29 +/- 0.04 vs. group P: 7.32 +/- 0.04; P=0.01) and venous pH (group E: 7.34 +/- 0.04 vs. group P: 7.38 +/- 0.05; P=0.002) were significantly greater in group P than in group E. UA base excess was significantly less in group E (-2.83 +/- 0.94 mEq/L) than in group P (-1.61 +/- 1.04 mEq/L; P<0.001). Apgar scores at 1, 5 and 10min and neurobehavioural scores at 2-4 h, 24 h and 48 h were similar in the two groups (P>0.05). CONCLUSIONS: Phenylephrine 100 mug and ephedrine 6 mg had similar efficacy in the treatment of maternal hypotension during spinal anaesthesia for elective caesarean delivery. Neonates in group P had significantly higher umbilical arterial pH and base excess values than those in group E, which is consistent with other studies. SN - 1532-3374 UR - https://www.unboundmedicine.com/medline/citation/19665364/Maternal_and_neonatal_effects_of_bolus_administration_of_ephedrine_and_phenylephrine_during_spinal_anaesthesia_for_caesarean_delivery:_a_randomised_study_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0959-289X(09)00049-1 DB - PRIME DP - Unbound Medicine ER -