Tags

Type your tag names separated by a space and hit enter

Randomised double-blind comparison of bolus phenylephrine or ephedrine for treatment of hypotension in women with pre-eclampsia undergoing caesarean section.
Anaesthesia 2018; 73(7):839-846A

Abstract

Treatment of post-spinal hypotension during caesarean section assumes special concern in pre-eclamptic patients due to a compromised fetoplacental circulation and increased risk of placental hypoperfusion. Phenylephrine and ephedrine are the most commonly used vasopressors, although the best choice is still not clear. We studied 80 pre-eclamptic women with a singleton pregnancy who underwent caesarean section with spinal anaesthesia, and who developed hypotension defined as a decrease in systolic arterial pressure ≥ 20% from baseline or absolute value < 100 mmHg. Women were randomly allocated to receive phenylephrine 50 μg or ephedrine 4 mg boluses for treatment of hypotension. Blood pressure changes following vasopressor administration were similar in both groups, but heart rate remained higher after ephedrine at all time-points. The primary outcome measure of umbilical artery pH was 7.26 (0.11) in the phenylephrine group and 7.25 (0.09) in the ephedrine group (p = 0.86). The incidence of neonatal acidosis (umbilical artery pH < 7.20) was 9 (22.5%) in the phenylephrine group and 11 (27.5%) in the ephedrine group (p = 0.80). Other secondary outcome measures were comparable. In conclusion, phenylephrine 50 μg and ephedrine 4 mg, administered as intravenous boluses to treat post-spinal hypotension during caesarean section in pre-eclamptic patients, resulted in similar fetal acid-base values, were equally effective in treating hypotension and were associated with good maternal and neonatal outcome.

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.

Pub Type(s)

Comparative Study
Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

29520867

Citation

Mohta, M, et al. "Randomised Double-blind Comparison of Bolus Phenylephrine or Ephedrine for Treatment of Hypotension in Women With Pre-eclampsia Undergoing Caesarean Section." Anaesthesia, vol. 73, no. 7, 2018, pp. 839-846.
Mohta M, Duggal S, Chilkoti GT. Randomised double-blind comparison of bolus phenylephrine or ephedrine for treatment of hypotension in women with pre-eclampsia undergoing caesarean section. Anaesthesia. 2018;73(7):839-846.
Mohta, M., Duggal, S., & Chilkoti, G. T. (2018). Randomised double-blind comparison of bolus phenylephrine or ephedrine for treatment of hypotension in women with pre-eclampsia undergoing caesarean section. Anaesthesia, 73(7), pp. 839-846. doi:10.1111/anae.14268.
Mohta M, Duggal S, Chilkoti GT. Randomised Double-blind Comparison of Bolus Phenylephrine or Ephedrine for Treatment of Hypotension in Women With Pre-eclampsia Undergoing Caesarean Section. Anaesthesia. 2018;73(7):839-846. PubMed PMID: 29520867.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Randomised double-blind comparison of bolus phenylephrine or ephedrine for treatment of hypotension in women with pre-eclampsia undergoing caesarean section. AU - Mohta,M, AU - Duggal,S, AU - Chilkoti,G T, Y1 - 2018/03/09/ PY - 2018/02/02/accepted PY - 2018/3/10/pubmed PY - 2019/3/16/medline PY - 2018/3/10/entrez KW - caesarean section: morbidity KW - ephedrine KW - phenylephrine KW - pre-eclampsia KW - spinal hypotension: treatment SP - 839 EP - 846 JF - Anaesthesia JO - Anaesthesia VL - 73 IS - 7 N2 - Treatment of post-spinal hypotension during caesarean section assumes special concern in pre-eclamptic patients due to a compromised fetoplacental circulation and increased risk of placental hypoperfusion. Phenylephrine and ephedrine are the most commonly used vasopressors, although the best choice is still not clear. We studied 80 pre-eclamptic women with a singleton pregnancy who underwent caesarean section with spinal anaesthesia, and who developed hypotension defined as a decrease in systolic arterial pressure ≥ 20% from baseline or absolute value < 100 mmHg. Women were randomly allocated to receive phenylephrine 50 μg or ephedrine 4 mg boluses for treatment of hypotension. Blood pressure changes following vasopressor administration were similar in both groups, but heart rate remained higher after ephedrine at all time-points. The primary outcome measure of umbilical artery pH was 7.26 (0.11) in the phenylephrine group and 7.25 (0.09) in the ephedrine group (p = 0.86). The incidence of neonatal acidosis (umbilical artery pH < 7.20) was 9 (22.5%) in the phenylephrine group and 11 (27.5%) in the ephedrine group (p = 0.80). Other secondary outcome measures were comparable. In conclusion, phenylephrine 50 μg and ephedrine 4 mg, administered as intravenous boluses to treat post-spinal hypotension during caesarean section in pre-eclamptic patients, resulted in similar fetal acid-base values, were equally effective in treating hypotension and were associated with good maternal and neonatal outcome. SN - 1365-2044 UR - https://www.unboundmedicine.com/medline/citation/29520867/Randomised_double_blind_comparison_of_bolus_phenylephrine_or_ephedrine_for_treatment_of_hypotension_in_women_with_pre_eclampsia_undergoing_caesarean_section_ L2 - https://doi.org/10.1111/anae.14268 DB - PRIME DP - Unbound Medicine ER -