The role of vasopressors in the management of hypotension induced by spinal and epidural anaesthesia

Morgan, P.

doi:10.1007/bf03009863

Cited by 89 publications

(59 citation statements)

References 75 publications

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“…Intravenous infusion of vasopressors is associated with better control of arterial pressure and fewer maternal side-effects compared with intermittent intravenous bolus doses [28,29] or intramuscular administration [30]. Prophylactic administration of ephedrine is associated with a higher incidence of fetal acidaemia [13].…”

Section: ó 2005 Blackwell Publishing Ltdmentioning

confidence: 99%

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

Kansal¹,

Mohta

Sethi³

et al. 2004

Anaesthesia

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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.

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Section: ó 2005 Blackwell Publishing Ltdmentioning

confidence: 99%

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

Kansal¹,

Mohta

Sethi³

et al. 2004

Anaesthesia

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“…(Husaini and Russell 1998;Morgan 1994;Turkoz et al 2002) Ephedrine, by beta 1 stimulation, causes an increase of cardiac output and indirectly effects vasoconstriction through the release of norepinephrine. Repeated administration of ephedrine, however, diminishes the vasoconstrictive effect, since the norepinephrine supply dwindles.…”

Section: Discussionmentioning

confidence: 99%

Comparison of Norepinephrine and Cafedrine/Theodrenaline Regimens for Maintaining Maternal Blood Pressure during Spinal Anaesthesia for Caesarean Section

Hoyme¹,

Scheungraber²,

Reinhart³

et al. 2015

GYNE

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Common phenomena of spinal anaesthesia for caesarean sections are hypotension and cardiovascular depression, both of which require immediate action. Akrinor® (theodrenaline and cafedrine), a sympathomimetic agent commonly used in Germany for such cases, was phased out with little notice at the end of 2005. Phenylephrine was not and is not an approved drug. There were no significant differences between the groups regarding arterial umbilical blood pH or Apgar scores. Despite treatment, prolonged hypotension (>10 minutes) occurred in both groups (group A: n=10; group NE: n=12). The neonatal arterial blood pH did not show any significant difference between the two groups. Two patients in group A, none in group NE, suffered from clinically relevant tachycardia (>50% increase of baseline). Our results thus suggest that norepinephrine is a safe vasopressor suitable for the treatment of peripartal hypotension without any risk of neonatal acidosis in elective caesarean section under spinal anaesthesia.

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“…When used as a bolus, the recommended doses have varied widely from 20 to 100 lg. [7][8][9][10][11][12] Current practice at our institution is to give 100-lg bolus doses to maintain systolic blood pressure at control levels, which still results in about a 10-15% incidence of pre-delivery hypotension (systolic pressure <80% of control value) in our patients. Unfortunately, a dose-response study is not available in the literature, so it is impossible to know whether this dose is the most appropriate.…”

Section: Introductionmentioning

confidence: 95%

ED95 of phenylephrine to prevent spinal-induced hypotension and/or nausea at elective cesarean delivery

Tanaka

Balki

Parkes

et al. 2009

International Journal of Obstetric Anesthesia

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The role of vasopressors in the management of hypotension induced by spinal and epidural anaesthesia

Cited by 89 publications

References 75 publications

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

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

Comparison of Norepinephrine and Cafedrine/Theodrenaline Regimens for Maintaining Maternal Blood Pressure during Spinal Anaesthesia for Caesarean Section

ED95 of phenylephrine to prevent spinal-induced hypotension and/or nausea at elective cesarean delivery

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