British Journal of Anaesthesia, 1994, Vol. 73, No. 4 471-474
© 1994 The Board of Management and Trustees of the British Journal of Anaesthesia
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Spinal anaesthesia for Caesarean section: comparison of infusions of phenylephrine and ephedrine
Department of Anaesthetics, Birmingham Maternity Hospital Edgbaston, Birmingham B15 2TG
* Present address, for correspondence: Department of Anaesthesia, Heartlands Hospital, Bordesley Green East, Birmingham B9 5SS
Maternal cardiovascular changes and neonatal acid-base status were assessed in 29 healthy women undergoing elective lower segment Caesarean section under spinal anaesthesia. The patients were allocated randomly to one of three groups to receive an i.v. infusion of one of the following: ephedrine 1 mg min–1 (group E1: n = 10), ephedrine 2mg min–1 (group E2: n = 9), or phenylephrine 10 µg min–1 (group P: n = 10). Invasive arterial pressure was monitored continuously and if hypotension occurred (defined as a 20% decrease from baseline, taken after iv. preload administration), bolus doses of either ephedrine (6 mg in groups E1 and E2) or phenylephrine (20 µg in group P) were given. Only four patients became hypotensive in group E2, compared with eight patients in group E1 and nine patients in group P. The total time that the patients remained hypotensive was greatest in group P (P < 0.005), less in group E1 and least in group E2. Neonatal Apgar scores and acid-base profiles were similar in all three groups. In this study, an infusion of phenylephrine 10 µg min–1 with bolus doses of 20 µg was shown to be significantly less effective in maintaining systolic arterial pressure within 20% limits of baseline compared with an infusion of ephedrine 1 or 2 mg min–1 with bolus doses of 6mg
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