Document Detail


Maternal and neonatal effects of bolus administration of ephedrine and phenylephrine during spinal anaesthesia for caesarean delivery: a randomised study.
MedLine Citation:
PMID:  19665364     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Maternal haemodynamic changes and neonatal well-being following bolus administration of ephedrine and phenylephrine were compared in 60 term parturients undergoing elective caesarean delivery under spinal anaesthesia. METHODS: In a randomised double-blind study, women received boluses of either ephedrine 6 mg (group E; n=30) or phenylephrine 100 microg (group P; n=30) whenever maternal systolic pressure was 80% of baseline. RESULTS: Changes in systolic pressure were comparable in the two groups. There were no differences in the incidence of bradycardia (group E: 0% vs. group P: 16.7%; P>0.05), nausea (group E: 13% vs. group: P 0; P>0.05) and vomiting (group E: 3.3% vs. group P: 0; P>0.05). Umbilical artery (UA) pH (group E: 7.29 +/- 0.04 vs. group P: 7.32 +/- 0.04; P=0.01) and venous pH (group E: 7.34 +/- 0.04 vs. group P: 7.38 +/- 0.05; P=0.002) were significantly greater in group P than in group E. UA base excess was significantly less in group E (-2.83 +/- 0.94 mEq/L) than in group P (-1.61 +/- 1.04 mEq/L; P<0.001). Apgar scores at 1, 5 and 10min and neurobehavioural scores at 2-4 h, 24 h and 48 h were similar in the two groups (P>0.05). CONCLUSIONS: Phenylephrine 100 mug and ephedrine 6 mg had similar efficacy in the treatment of maternal hypotension during spinal anaesthesia for elective caesarean delivery. Neonates in group P had significantly higher umbilical arterial pH and base excess values than those in group E, which is consistent with other studies.
Authors:
S Prakash; V Pramanik; H Chellani; S Salhan; A R Gogia
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Publication Detail:
Type:  Comparative Study; Journal Article; Randomized Controlled Trial     Date:  2009-08-07
Journal Detail:
Title:  International journal of obstetric anesthesia     Volume:  19     ISSN:  1532-3374     ISO Abbreviation:  Int J Obstet Anesth     Publication Date:  2010 Jan 
Date Detail:
Created Date:  2010-01-19     Completed Date:  2010-03-25     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9200430     Medline TA:  Int J Obstet Anesth     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  24-30     Citation Subset:  IM    
Copyright Information:
Copyright 2009 Elsevier Ltd. All rights reserved.
Affiliation:
Department of Anaesthesia and Intensive Care, Vardhman Mahavir Medical College and Safdarjang Hospital, New Delhi, India. drsunilprakash@gmail.com
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MeSH Terms
Descriptor/Qualifier:
Acid-Base Equilibrium
Adult
Anesthesia, Obstetrical* / adverse effects
Anesthesia, Spinal* / adverse effects
Anti-Ulcer Agents / therapeutic use
Antiemetics / therapeutic use
Apgar Score
Cesarean Section*
Double-Blind Method
Ephedrine / administration & dosage,  therapeutic use*
Female
Hemodynamics / drug effects
Humans
Hypotension / drug therapy*,  etiology
Infant, Newborn
Metoclopramide / therapeutic use
Pain Measurement
Phenylephrine / administration & dosage,  therapeutic use*
Postoperative Nausea and Vomiting / prevention & control
Pregnancy
Ranitidine / therapeutic use
Sample Size
Vasoconstrictor Agents / administration & dosage,  therapeutic use*
Chemical
Reg. No./Substance:
0/Anti-Ulcer Agents; 0/Antiemetics; 0/Vasoconstrictor Agents; 299-42-3/Ephedrine; 364-62-5/Metoclopramide; 59-42-7/Phenylephrine; 66357-35-5/Ranitidine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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