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Effect of different phenylephrine bolus doses for treatment of hypotension during spinal anaesthesia in patients undergoing elective caesarean section.
Anaesth Intensive Care. 2015 Jan; 43(1):74-80.AI

Abstract

The efficacy of phenylephrine might be improved by giving doses higher than that traditionally used (100 µg). This study compared the effects of three initial bolus doses of intravenous phenylephrine; 100 µg (group P100), 125 µg (group P125) and 150 µg (group P150), for the treatment of post-spinal hypotension in patients undergoing elective caesarean delivery. If hypotension was not corrected by this dose, additional boluses of 25 µg were given every minute. Further hypotensive episodes were treated with half the initial bolus dose, followed by 25 µg boluses, as required. Umbilical arterial and venous blood samples were obtained for blood gas analysis and Apgar scores recorded. One hundred and twenty subjects (40 per group) who developed post-spinal hypotension (75%) were included in this randomised, double blind trial. Although systolic blood pressure was higher at certain time-points after 150 µg phenylephrine, there were no statistically significant differences in the effectiveness of the first bolus of phenylephrine to treat hypotension (85%, 95% and 95% in groups P100, P125 and P150, respectively, P=0.215); the additional dose of phenylephrine after the first bolus (P=0.810); the number of additional boluses (P=0.318) or of hypotensive episodes (P=0.118). There were no significant differences in the number of patients developing reactive hypertension or bradycardia, in maternal side-effects or in neonatal outcomes. Although the study may have been underpowered, initial phenylephrine bolus doses of 100 µg, 125 µg and 150 µg did not significantly differ in efficacy to treat post-spinal hypotension in these patients.

Authors+Show Affiliations

Department of Anaesthesiology and Critical Care, University College of Medical Sciences and Guru Teg Bahadur Hospital, Delhi, India.Department of Anaesthesiology and Critical Care, University College of Medical Sciences and Guru Teg Bahadur Hospital, Delhi, India.Department of Anaesthesiology and Critical Care, University College of Medical Sciences and Guru Teg Bahadur Hospital, Delhi, India.Department of Anaesthesiology and Critical Care, University College of Medical Sciences and Guru Teg Bahadur Hospital, Delhi, India.

Pub Type(s)

Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

25579292

Citation

Mohta, M, et al. "Effect of Different Phenylephrine Bolus Doses for Treatment of Hypotension During Spinal Anaesthesia in Patients Undergoing Elective Caesarean Section." Anaesthesia and Intensive Care, vol. 43, no. 1, 2015, pp. 74-80.
Mohta M, Harisinghani P, Sethi AK, et al. Effect of different phenylephrine bolus doses for treatment of hypotension during spinal anaesthesia in patients undergoing elective caesarean section. Anaesth Intensive Care. 2015;43(1):74-80.
Mohta, M., Harisinghani, P., Sethi, A. K., & Agarwal, D. (2015). Effect of different phenylephrine bolus doses for treatment of hypotension during spinal anaesthesia in patients undergoing elective caesarean section. Anaesthesia and Intensive Care, 43(1), 74-80.
Mohta M, et al. Effect of Different Phenylephrine Bolus Doses for Treatment of Hypotension During Spinal Anaesthesia in Patients Undergoing Elective Caesarean Section. Anaesth Intensive Care. 2015;43(1):74-80. PubMed PMID: 25579292.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Effect of different phenylephrine bolus doses for treatment of hypotension during spinal anaesthesia in patients undergoing elective caesarean section. AU - Mohta,M, AU - Harisinghani,P, AU - Sethi,A K, AU - Agarwal,D, PY - 2015/1/13/entrez PY - 2015/1/13/pubmed PY - 2015/3/4/medline KW - elective caesarean section KW - hypotension KW - phenylephrine KW - post-spinal hypotension KW - vasopressor SP - 74 EP - 80 JF - Anaesthesia and intensive care JO - Anaesth Intensive Care VL - 43 IS - 1 N2 - The efficacy of phenylephrine might be improved by giving doses higher than that traditionally used (100 µg). This study compared the effects of three initial bolus doses of intravenous phenylephrine; 100 µg (group P100), 125 µg (group P125) and 150 µg (group P150), for the treatment of post-spinal hypotension in patients undergoing elective caesarean delivery. If hypotension was not corrected by this dose, additional boluses of 25 µg were given every minute. Further hypotensive episodes were treated with half the initial bolus dose, followed by 25 µg boluses, as required. Umbilical arterial and venous blood samples were obtained for blood gas analysis and Apgar scores recorded. One hundred and twenty subjects (40 per group) who developed post-spinal hypotension (75%) were included in this randomised, double blind trial. Although systolic blood pressure was higher at certain time-points after 150 µg phenylephrine, there were no statistically significant differences in the effectiveness of the first bolus of phenylephrine to treat hypotension (85%, 95% and 95% in groups P100, P125 and P150, respectively, P=0.215); the additional dose of phenylephrine after the first bolus (P=0.810); the number of additional boluses (P=0.318) or of hypotensive episodes (P=0.118). There were no significant differences in the number of patients developing reactive hypertension or bradycardia, in maternal side-effects or in neonatal outcomes. Although the study may have been underpowered, initial phenylephrine bolus doses of 100 µg, 125 µg and 150 µg did not significantly differ in efficacy to treat post-spinal hypotension in these patients. SN - 0310-057X UR - https://www.unboundmedicine.com/medline/citation/25579292/Effect_of_different_phenylephrine_bolus_doses_for_treatment_of_hypotension_during_spinal_anaesthesia_in_patients_undergoing_elective_caesarean_section_ L2 - http://journals.sagepub.com/doi/full/10.1177/0310057X1504300111?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -