Prophylactic phenylephrine infusion for preventing hypotension during spinal anesthesia for cesarean delivery
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AbstractIn a randomized, double-blinded, controlled trial, we investigated the prophylactic infusion of IV phenylephrine for the prevention of hypotension during spinal anesthesia for cesarean delivery. Immediately after intrathecal injection, phenylephrine was infused at 100 mug/min (n = 26) for 3 min. From that point until delivery, phenylephrine was infused at 100 mug/min whenever systolic arterial blood pressure (SAP), measured each minute, was less than baseline. A control group (n = 24) received IV bolus phenylephrine 100 mug after each measurement of SAP <80% of baseline. Phenylephrine infusion decreased the incidence (6 [23%] of 26 versus 21 [88%] of 24; P < 0.0001), frequency, and magnitude (median minimum SAP, 106 mm Hg; interquartile range, 95-111 mm Hg; versus median, 80 mm Hg; range, 73-93 mm Hg; P < 0.0001) of hypotension compared with control. Heart rate was significantly slower over time in the infusion group compared with the control group (P < 0.0001). Despite a large total dose of phenylephrine administered to the infusion group compared with the control group (median, 1260 mug; interquartile range, 1010-1640 mug; versus median, 450 mug; interquartile range, 300-750 mug; P < 0.0001), umbilical cord blood gases and Apgar scores were similar. One patient in each group had umbilical arterial pH <7.2. Prophylactic phenylephrine infusion is a simple, safe, and effective method of maintaining arterial blood pressure during spinal anesthesia for cesarean delivery.
All Author(s) ListKee WDN, Khaw KS, Ng FF, Lee BB
Name of ConferenceAnnual Meeting of the American-Society-of-Anesthesiologists
Start Date of Conference11/10/2003
End Date of Conference15/10/2003
Place of ConferenceSAN FRANCISCO
Journal nameAnesthesia and Analgesia
Year2004
Month3
Day1
Volume Number98
Issue Number3
PublisherLIPPINCOTT WILLIAMS & WILKINS
Pages815 - 821
ISSN0003-2999
eISSN1526-7598
LanguagesEnglish-United Kingdom
Web of Science Subject CategoriesAnesthesiology; ANESTHESIOLOGY

Last updated on 2021-26-02 at 00:24