Korean J Anesthesiol.  2006 Sep;51(3):335-342. 10.4097/kjae.2006.51.3.335.

Comparison of Maternal and Fetal Effects of Ephedrine and Phenylephrine Infusion during Spinal Anesthesia for Cesarean Section

• Jung SW
• Kim EJ
• Min BW
• Ban JS
• Lee SG
• Lee JH

• KMID: 2237434
• DOI: http://doi.org/10.4097/kjae.2006.51.3.335

Abstract

BACKGROUD: Ephedrine has been most commonly used for the prevention and treatment of hypotension occurring frequently during spinal anesthesia for cesarean section. But recent studies reported that phenylephrine was more effective for treatment of maternal hypotension and for prevention of fetal acidosis than ephedrine. We compared effect of phenylephrine, ephedrine, and ephedrine combined with phenylephrine to maternal hypotension and fetal acidosis.
METHODS
This study compared ephedrine 2 mg/min infusion with 6 mg bolus (n = 30), phenylephrine 33.3microgram/min infusion with 50microgram bolus (n = 30), and ephedrine combined phenylephrine with half the dose infusion rate & bolus (n = 30). Hypotension, defined as systolic blood pressure less than 100 mmHg and less than 80% of baseline, was treated with additional bolus injection.
RESULTS
In ephedrine group, the number of bolus given for hypotension was larger than other groups (P < 0.001), the incidence of hypotension was also higher than other groups (P = 0.02). The heart rate was lower in phenylephrine group than other groups, but bradycardia which needs to be treated didn't occur. Umbilical blood gas analysis and Apgar score were similar for three groups, but only one patient in ephedrine group had fetal acidosis (pH = 7.130). Nausea and vomiting were more frequent in ephedrine group than other groups.
CONCLUSIONS
In our study, giving phenylephrine alone was more effective in the prevention and treatment of maternal hypotension and nausea & vomiting than giving ephedrine alone or combined phenylephrine.

Keyword

cesarean section; ephedrine; fetal acidosis; maternal hypotension; phenylephrine; spinal anesthesia

MeSH Terms

Acidosis
Anesthesia, Spinal*
Apgar Score
Blood Gas Analysis
Blood Pressure
Bradycardia
Cesarean Section*
Ephedrine*
Female
Heart Rate
Humans
Hypotension
Incidence
Nausea
Phenylephrine*
Pregnancy
Vomiting
Ephedrine
Phenylephrine