Etilefrine vs. phenylephrine for hypotension during spinal anesthesia for cesarean section: Multicenter, randomized, double blind controlled clinical trial

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• 作者：Diana Bolañ ; os-Arboleda^a ; Nelson Javier Fonseca-Ruiz^b ; ^{nelson.fonseca@upb.edu.co" class="auth_mail" title="E-mail the corresponding author} ; Nury Isabel Socha-Garc&iacute ; a^c ; Edward Garc&iacute ; a-Peñ ; uela^a ; Germá ; n Monsalve-Mej&iacute ; a^d
• 关键词：Phenylephrine ; Spinal ; anesthesia ; Cesá ; rean section ; Etilefrine ; Hypotension
• 刊名：Colombian Journal of Anesthesiology
• 出版年：2016
• 出版时间：April-June 2016
• 年：2016
• 卷：44
• 期：2
• 页码：89-96
• 全文大小：1030 K

文摘

Hypotension after spinal anesthesia in cesarean section should be minimized. The use of vasopressors is an effective measure to treat hypotension. The objective of this paper is to compare the safety and effectiveness of etilefrine vs. phenylephrine in the management of this condition.

Methods

This multicenter, double-blind trial between August 2009 and November 2010 included 196 patients with hypotension during spinal anesthesia for cesarean delivery; the patients were randomized to receive etilefrine or phenylephrine as vasopressor. The primary outcome was the fetal umbilical arterial pH. The secondary outcomes were: fetal acidosis (umbilical arterial pH < 7.20), Apgar score at 1 and 5 min, need for intubation and admission to the neonatal intensive care unit for newborns, and time of hypotension, total dose of vasopressor, atropine requirement, intravenous fluids volume and incidence of nausea and vomiting in mothers.

Results

98 patients received etilefrine and 98 phenylephrine. There were no differences in umbilical arterial pH (7.27 vs. 7.28, respectively, P = 0.493). The total dose of vasopressor (5.66 vs. 6.51 ml, respectively, P = 0.024) and total time of hypotension (2.78 vs. 3.25 min, respectively, P = 0.021) were lower in the etilefrine group. Other outcomes studied showed no statistically significant differences.

Conclusion

Etilefrine and phenylephrine are equally effective for the treatment of hypotension during spinal anesthesia for cesarean delivery. This study found no difference in the maternal or fetal outcomes.