English (United Kingdom)

https://curated-unify.zendy.io/wp-json/zendy-region/v1/featured_content/oa?rat=en

https://curated-unify.zendy.io/wp-json/zendy-region/v1/highlighted_journal/

Global: Zendy Plus annual

Presents the access of premium content as premium feature

Premium Content

Presents the keyphrase highlighting as premium feature

Keyphrase Highlighting

Presents the summarisation as premium feature

Summarisation

Insights

Presents the pdf analysis as premium feature

PDF Analysis

Presents the zaia usage as premium feature

ZAIA

Global: Zendy Tools annual

Global: Zendy Free Plan

Global: Zendy Tools monthly

Global: Zendy Plus monthly

Background:  During caesarean section spinal anesthesia may provoke maternal hypotension that we prevent by administration of phenylephrine and/or ephedrine. Phenylephrine is however reported to reduce the near infrared spectroscopy-determined frontal lobe oxygenation (ScO 2 ) but whether that is the case for patients exposed to spinal anesthesia is not known.   Objectives:  To evaluate the impact of phenylephrine vs. ephedrine on ScO 2 during caesarean section with spinal anesthesia in a single center, open-label parallel-group study with balanced randomization of 24 women (1:1). Secondary aims were to compare the effect of the two drugs on maternal hemodynamics and fetal heart rate.   Intervention:  Ephedrine (0.8–3.3 mg/min)  vs.  phenylephrine infusion (0.02–0.07 mg/min).   Results:  For the duration of surgery, administration of ephedrine maintained ScO 2  (compared to baseline +2.1 ± 2.8%; mean ± SE, while phenylephrine reduced ScO 2  (−8.6 ± 2.8%;  p  = 0.005) with a 10.7% difference in ScO 2 between groups ( p  = 0.0106). Also maternal heart rate was maintained with ephedrine (+3 ± 3 bpm) but decreased with phenylephrine (−11 ± 3 bpm); difference 14 bpm ( p  = 0.0053), but no significant difference in mean arterial pressure ( p  = 0.1904) or CO ( p  = 0.0683) was observed between groups. The two drugs also elicited an equal increase in fetal heart rate (by 19 ± 3 vs. 18 ± 3 bpm;  p  = 0.744).   Conclusion:  In the choice between phenylephrine and ephedrine for maintenance of blood pressure during caesarean section with spinal anesthesia, ephedrine maintains frontal lobe oxygenation and maternal heart rate with a similar increase in fetal heart rate as elicited by phenylephrine.   Trial registration:  Clinical trials NCT 01509521 and EudraCT 2001 006103 35.

frontiers in physiology

Effect of phenylephrine vs. ephedrine on frontal lobe oxygenation during caesarean section with spinal anesthesia: an open label randomized controlled trial