Randomised trial of intravenous infusion of ephedrine or mephentermine for management of hypotension during spinal anaesthesia for Caesarean section

Abstract

SummaryThis study compared the effects of intravenous infusions of ephedrine and mephentermine for maintenance of maternal arterial pressure and neonatal outcome in pregnant women receiving subarachnoid block for lower segment Caesarean section. Sixty patients who developed hypotension following subarachnoid block for Caesarean section were randomly divided into two groups of 30 each to receive an intravenous infusion of ephedrine or mephentermine. Hypotension was defined as a decrease in systolic blood pressure of ‡ 20% from the baseline value or an absolute value of <100 mmHg, whichever was higher. The vasopressor infusion was titrated to maintain systolic blood pressure between 'hypotension' and baseline values. Baseline haemodynamic parameters, haemodynamic changes subsequent to the start of vasopressor infusion, duration of hypotension and amount of vasopressor required were statistically similar for both groups. Neonatal APGAR scores and acid-base profiles were also comparable. To conclude, mephentermine can be used as safely and effectively as ephedrine for the management of hypotension during spinal anaesthesia in patients undergoing elective Caesarean section.

Mephentermine: rediscovering its biology and use, misuse and their implications

“…: SCID-CV) were not applied for the diagnosis of depression. This is also a limitation of the study by Margis et al 2 The total score in the PDQ-39 and its subscales/dimensions strongly correlated with the total score in the GDS-15. The group of patients with current depression (GDS-15 ≥ 8) had higher scores (p < 0.0001) in the PDQ-39 and its dimensions (Table 1).…”

“…Thus, we have read with great interest the article by Margis et al in which the authors assessed the influence of depressive symptoms on the quality of life of PD patients. 2 The authors observed that the Geriatric Depression Scale (GDS) score was positively associated with the total score in the World Health Organization Quality of Life Assessment for older adults and five of its six domains.…”

“…To the same end as Margis et al, 2 we have recently used the 39-item Parkinson's Disease Questionnaire (PDQ-39) and its eight dimensions and the 15-item GDS (GDS-15) to assess quality of life and depressive symptoms in PD patients, respectively. We divided the patients into two groups (PD without depression and PD with depression) according to the GDS-15 cutoff score of eight proposed for the screening of depression in PD.…”

“…2 It has also been used as a nasal decongestant. 3 Nowadays, it is mainly used as a stimulant administered to disease-recovering competition animals.…”

Effectiveness of Intravenous Prophylactic Phenylephrine for the Prevention of Spinal Anaesthesia Induced Hypotension during Caesarean Section. A Prospective Observational Study

“…Post spinal hypotension (PSH): Reduction of systolic blood pressure from baseline by 20% following spinal anesthesia [43,44].…”