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A review of the impact of phenylephrine administration on maternal hemodynamics and maternal and neonatal outcomes in women undergoing cesarean delivery under spinal anesthesia.
Anesth Analg 2012; 114(2):377-90A&A

Abstract

Phenylephrine is effective for the management of spinal anesthesia-induced hypotension in parturients undergoing cesarean delivery under spinal anesthesia. While ephedrine was previously considered the vasopressor of choice in obstetric patients, phenylephrine is increasingly being used. This is largely due to studies suggesting improved fetal acid-base status with the use of phenylephrine as well as the low incidence of hypotension and its related side effects with prophylactic phenylephrine regimens. This review highlights the effects of phenylephrine compared with ephedrine on maternal hemodynamics (arterial blood pressure, heart rate, and cardiac output), and occurrence of intraoperative nausea and vomiting. The impact of the administration of phenylephrine as a bolus for the treatment of established hypotension compared with its administration as a prophylactic infusion is discussed. This article also reviews the impact of phenylephrine compared with ephedrine on uteroplacental perfusion, and fetal outcomes such as neonatal acid-base status and Apgar scores. The optimum dosing regimen for phenylephrine administration is also discussed.

Authors+Show Affiliations

Department of Anesthesiology, Duke University Medical Center, Durham, NC 27710, USA. habib001@mc.duke.edu

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

22104076

Citation

Habib, Ashraf S.. "A Review of the Impact of Phenylephrine Administration On Maternal Hemodynamics and Maternal and Neonatal Outcomes in Women Undergoing Cesarean Delivery Under Spinal Anesthesia." Anesthesia and Analgesia, vol. 114, no. 2, 2012, pp. 377-90.
Habib AS. A review of the impact of phenylephrine administration on maternal hemodynamics and maternal and neonatal outcomes in women undergoing cesarean delivery under spinal anesthesia. Anesth Analg. 2012;114(2):377-90.
Habib, A. S. (2012). A review of the impact of phenylephrine administration on maternal hemodynamics and maternal and neonatal outcomes in women undergoing cesarean delivery under spinal anesthesia. Anesthesia and Analgesia, 114(2), pp. 377-90. doi:10.1213/ANE.0b013e3182373a3e.
Habib AS. A Review of the Impact of Phenylephrine Administration On Maternal Hemodynamics and Maternal and Neonatal Outcomes in Women Undergoing Cesarean Delivery Under Spinal Anesthesia. Anesth Analg. 2012;114(2):377-90. PubMed PMID: 22104076.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A review of the impact of phenylephrine administration on maternal hemodynamics and maternal and neonatal outcomes in women undergoing cesarean delivery under spinal anesthesia. A1 - Habib,Ashraf S, Y1 - 2011/11/21/ PY - 2011/11/23/entrez PY - 2011/11/23/pubmed PY - 2012/3/9/medline SP - 377 EP - 90 JF - Anesthesia and analgesia JO - Anesth. Analg. VL - 114 IS - 2 N2 - Phenylephrine is effective for the management of spinal anesthesia-induced hypotension in parturients undergoing cesarean delivery under spinal anesthesia. While ephedrine was previously considered the vasopressor of choice in obstetric patients, phenylephrine is increasingly being used. This is largely due to studies suggesting improved fetal acid-base status with the use of phenylephrine as well as the low incidence of hypotension and its related side effects with prophylactic phenylephrine regimens. This review highlights the effects of phenylephrine compared with ephedrine on maternal hemodynamics (arterial blood pressure, heart rate, and cardiac output), and occurrence of intraoperative nausea and vomiting. The impact of the administration of phenylephrine as a bolus for the treatment of established hypotension compared with its administration as a prophylactic infusion is discussed. This article also reviews the impact of phenylephrine compared with ephedrine on uteroplacental perfusion, and fetal outcomes such as neonatal acid-base status and Apgar scores. The optimum dosing regimen for phenylephrine administration is also discussed. SN - 1526-7598 UR - https://www.unboundmedicine.com/medline/citation/22104076/A_review_of_the_impact_of_phenylephrine_administration_on_maternal_hemodynamics_and_maternal_and_neonatal_outcomes_in_women_undergoing_cesarean_delivery_under_spinal_anesthesia_ L2 - http://dx.doi.org/10.1213/ANE.0b013e3182373a3e DB - PRIME DP - Unbound Medicine ER -