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Randomised double‐blinded comparison of phenylephrine vs ephedrine for maintaining blood pressure during spinal anaesthesia for non‐elective Caesarean section *
Author(s) -
Ngan Kee W. D.,
Khaw K. S.,
Lau T. K.,
Ng F. F.,
Chui K.,
Ng K. L.
Publication year - 2008
Publication title -
anaesthesia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.839
H-Index - 117
eISSN - 1365-2044
pISSN - 0003-2409
DOI - 10.1111/j.1365-2044.2008.05635.x
Subject(s) - medicine , ephedrine , phenylephrine , anesthesia , blood pressure , caesarean section , interquartile range , vomiting , nausea , spinal anesthesia , isoflurane , surgery , pregnancy , biology , genetics
Summary In a randomised, double‐blinded study, we compared boluses of phenylephrine 100 μg with ephedrine 10 mg for treating hypotension (systolic blood pressure < 100 mmHg) in 204 patients having non‐elective Caesarean section under spinal anaesthesia. Umbilical arterial (UA) and venous (UV) pH and base excess were similar between groups. In the ephedrine group, UA lactate concentration was higher (median 2.6 [interquartile range 2.3–3.3] vs 2.4 [1.9–3.0] mmol.l −1 , p = 0.002) and UV lactate concentration was higher (2.5 [2.2–3.2] vs 2.3 [1.9–2.8] mmol.l −1 , p = 0.016) and more patients had nausea or vomiting (12.7% vs 3.9%, p = 0.02). Clinical neonatal outcome was similar. Of the protocol‐compliant patients ( n = 148), UA P o 2 and UV P o 2 were lower in the phenylephrine group although oxygen content was similar. We conclude that phenylephrine and ephedrine are both suitable vasopressors for use in non‐elective Caesarean sections.