Skip to content
Home
About Us
Resources
Profiles Metrics
Authors Directory
Institutions Directory
Top Authors
Top Institutions
Top Sponsors
AI Digest
Contact Us
Menu
Home
About Us
Resources
Profiles Metrics
Authors Directory
Institutions Directory
Top Authors
Top Institutions
Top Sponsors
AI Digest
Contact Us
Home
About Us
Resources
Profiles Metrics
Authors Directory
Institutions Directory
Top Authors
Top Institutions
Top Sponsors
AI Digest
Contact Us
Menu
Home
About Us
Resources
Profiles Metrics
Authors Directory
Institutions Directory
Top Authors
Top Institutions
Top Sponsors
AI Digest
Contact Us
Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Hemodynamic effects of ephedrine, phenylephrine, and the coadministration of phenylephrine with oxytocin during spinal anesthesia for elective cesarean delivery
Anesthesiology, Volume 111, No. 4, Year 2009
Notification
URL copied to clipboard!
Description
BACKGROUND: Hemodynamic responses to vasopressors used during spinal anesthesia for elective Cesarean delivery, have not been well described. This study compared the effects of bolus phenylephrine and ephedrine on maternal cardiac output (CO). The hypothesis was that phenylephrine, but not ephedrine, decreases CO when administered in response to hypotension during spinal anesthesia. METHODS: Forty-three patients were randomized to receive 80 μg of phenylephrine or 10 mg of ephedrine. Both pulse wave form analysis and transthoracic bioimpedance changes were used to estimate stroke volume in each patient. Hemodynamic responses to spinal anesthesia and oxytocin were also recorded. A subgroup of 20 patients was randomized to receive oxytocin compared with oxytocin plus 80 μg of phenylephrine after delivery. RESULTS: Mean CO and maximum absolute response in CO were significantly lower during the 150 s after phenylephrine administration than after ephedrine (6.2 vs. 8.1 l/min, P = 0.001, and 5.2 vs. 9.0 l/min, P < 0.0001, respectively for pulse wave form analysis, and 5.2 vs. 6.3 l/min, P = 0.01 and 4.5 vs. 6.7 l/min, P = 0.0001, respectively for bioimpedance changes). CO changes correlated with heart rate changes. Coadministration of phenylephrine obtunded oxytocin-induced decreases in systemic vascular resistance and increases in heart rate and CO. Trends in CO change were similar using either monitor. CONCLUSIONS: Bolus phenylephrine reduced maternal CO, and decreased CO when compared with ephedrine during elective spinal anesthesia for Cesarean delivery. CO changes correlated with heart rate changes after vasopressor administration, emphasizing the importance of heart rate as a surrogate indicator of CO. Coadministered phenylephrine obtunded hemodynamic responses to oxytocin. © 2009, the American Society of Anesthesiologists, Inc.
Authors & Co-Authors
Dyer, R. A.
South Africa, Observatory
Groote Schuur Hospital
Reed, Anthony R.
Unknown Affiliation
van Dyk, Dominique
Unknown Affiliation
Arcache, M. J.
Unknown Affiliation
Hodges, O.
Unknown Affiliation
Lombard, Carl J.
South Africa, Tygerberg
South African Medical Research Council
Greenwood, Jaime
United Kingdom, Nottingham
Nottingham University Hospitals Nhs Trust
James, Michael Frank M.
South Africa, Cape Town
University of Cape Town
Statistics
Citations: 264
Authors: 8
Affiliations: 4
Identifiers
Doi:
10.1097/ALN.0b013e3181b437e0
ISSN:
00033022
e-ISSN:
15281175
Research Areas
Health System And Policy
Maternal And Child Health
Noncommunicable Diseases