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Comparison of prophylactic phenylephrine and norepinephrine infusion on umbilical arterial pH and maternal blood pressure during spinal anaesthesia for caesarean delivery
BACKGROUND AND AIMS: Spinal anaesthesia induced maternal hypotension in parturients undergoing caesarean delivery may lead to neonatal acidosis and fall in umbilical artery pH. The aim of this study was to compare low dose norepinephrine infusion with phenylephrine to see the effect on umbilical art...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Wolters Kluwer - Medknow
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9116634/ https://www.ncbi.nlm.nih.gov/pubmed/35601041 http://dx.doi.org/10.4103/ija.ija_345_21 |
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author | Singh, Jasveer Singh, Jaskaran Mitra, Sukanya Anand, Lakesh K. Goel, Bharti Kaur, Manjeet |
author_facet | Singh, Jasveer Singh, Jaskaran Mitra, Sukanya Anand, Lakesh K. Goel, Bharti Kaur, Manjeet |
author_sort | Singh, Jasveer |
collection | PubMed |
description | BACKGROUND AND AIMS: Spinal anaesthesia induced maternal hypotension in parturients undergoing caesarean delivery may lead to neonatal acidosis and fall in umbilical artery pH. The aim of this study was to compare low dose norepinephrine infusion with phenylephrine to see the effect on umbilical arterial pH and maternal blood pressure during spinal anaesthesia for caesarean delivery. METHODS: In a randomised, double-blind study, 60 parturients belonging to American Society of Anesthesiologists grade II, age 18–35 years with singleton term pregnancy were divided into the phenylephrine group and norepinephrine group. Participants received prophylactic phenylephrine and norepinephrine infusion after spinal anaesthesia till the delivery of the baby at a fixed rate of 50 μg/min and 2.5 μg/min, respectively. The primary outcome was umbilical artery pH. Neonatal Apgar score, incidence of bradycardia and hypotension, number of boluses of vasopressor required and reactive hypertension were also compared. RESULTS: The umbilical arterial pH was comparable between the groups (p = 0.38). Apgar scores were comparable (p = 0.17). Incidence of bradycardia was higher in phenylephrine group without reaching statistical significance (43.3% vs. 20%, P = 0.052). Incidence of hypotension was more but not significant in norepinephrine group compared to phenylephrine group (16.7% vs. 10%, P = 0.44). Number of vasopressor boluses and reactive hypertension episodes were comparable between both groups (p = 0.09). CONCLUSION: Low dose (2.5 μg/min) intravenous infusion of norepinephrine is a suitable alternative to phenylephrine in the maintenance of umbilical arterial pH and maternal blood pressure. |
format | Online Article Text |
id | pubmed-9116634 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Wolters Kluwer - Medknow |
record_format | MEDLINE/PubMed |
spelling | pubmed-91166342022-05-19 Comparison of prophylactic phenylephrine and norepinephrine infusion on umbilical arterial pH and maternal blood pressure during spinal anaesthesia for caesarean delivery Singh, Jasveer Singh, Jaskaran Mitra, Sukanya Anand, Lakesh K. Goel, Bharti Kaur, Manjeet Indian J Anaesth Original Article BACKGROUND AND AIMS: Spinal anaesthesia induced maternal hypotension in parturients undergoing caesarean delivery may lead to neonatal acidosis and fall in umbilical artery pH. The aim of this study was to compare low dose norepinephrine infusion with phenylephrine to see the effect on umbilical arterial pH and maternal blood pressure during spinal anaesthesia for caesarean delivery. METHODS: In a randomised, double-blind study, 60 parturients belonging to American Society of Anesthesiologists grade II, age 18–35 years with singleton term pregnancy were divided into the phenylephrine group and norepinephrine group. Participants received prophylactic phenylephrine and norepinephrine infusion after spinal anaesthesia till the delivery of the baby at a fixed rate of 50 μg/min and 2.5 μg/min, respectively. The primary outcome was umbilical artery pH. Neonatal Apgar score, incidence of bradycardia and hypotension, number of boluses of vasopressor required and reactive hypertension were also compared. RESULTS: The umbilical arterial pH was comparable between the groups (p = 0.38). Apgar scores were comparable (p = 0.17). Incidence of bradycardia was higher in phenylephrine group without reaching statistical significance (43.3% vs. 20%, P = 0.052). Incidence of hypotension was more but not significant in norepinephrine group compared to phenylephrine group (16.7% vs. 10%, P = 0.44). Number of vasopressor boluses and reactive hypertension episodes were comparable between both groups (p = 0.09). CONCLUSION: Low dose (2.5 μg/min) intravenous infusion of norepinephrine is a suitable alternative to phenylephrine in the maintenance of umbilical arterial pH and maternal blood pressure. Wolters Kluwer - Medknow 2022-03 2022-03-25 /pmc/articles/PMC9116634/ /pubmed/35601041 http://dx.doi.org/10.4103/ija.ija_345_21 Text en Copyright: © 2022 Indian Journal of Anaesthesia https://creativecommons.org/licenses/by-nc-sa/4.0/This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms. |
spellingShingle | Original Article Singh, Jasveer Singh, Jaskaran Mitra, Sukanya Anand, Lakesh K. Goel, Bharti Kaur, Manjeet Comparison of prophylactic phenylephrine and norepinephrine infusion on umbilical arterial pH and maternal blood pressure during spinal anaesthesia for caesarean delivery |
title | Comparison of prophylactic phenylephrine and norepinephrine infusion on umbilical arterial pH and maternal blood pressure during spinal anaesthesia for caesarean delivery |
title_full | Comparison of prophylactic phenylephrine and norepinephrine infusion on umbilical arterial pH and maternal blood pressure during spinal anaesthesia for caesarean delivery |
title_fullStr | Comparison of prophylactic phenylephrine and norepinephrine infusion on umbilical arterial pH and maternal blood pressure during spinal anaesthesia for caesarean delivery |
title_full_unstemmed | Comparison of prophylactic phenylephrine and norepinephrine infusion on umbilical arterial pH and maternal blood pressure during spinal anaesthesia for caesarean delivery |
title_short | Comparison of prophylactic phenylephrine and norepinephrine infusion on umbilical arterial pH and maternal blood pressure during spinal anaesthesia for caesarean delivery |
title_sort | comparison of prophylactic phenylephrine and norepinephrine infusion on umbilical arterial ph and maternal blood pressure during spinal anaesthesia for caesarean delivery |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9116634/ https://www.ncbi.nlm.nih.gov/pubmed/35601041 http://dx.doi.org/10.4103/ija.ija_345_21 |
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