Background And Aims: There is limited data on the effects of norepinephrine on neonatal outcomes and maternal complications relative to other vasopressors. The study aimed to compare neonatal outcomes and maternal complications after bolus intravenous doses of phenylephrine and norepinephrine for post-spinal hypotension in elective caesarean section women.
Methods: This randomised study was done on 100 elective caesarean section women under spinal anaesthesia. Block randomisation divided women into two groups to receive intravenous phenylephrine 50 μg bolus (Group A) or norepinephrine 5 μg bolus (Group B) following post-spinal hypotension. Groups were evaluated and compared for umbilical arterial blood gas analysis, birth weight, APGAR (appearance, pulse, grimace, activity, and respiration) score, maternal haemodynamics, and complications. Kolmogorov-Smirnov and Shapiro-Wilk tests were used to verify data normality. Independent samples -test or Mann-Whitney U test was employed to compare continuous variables based on data normality, and the Chi-square test was used to determine categorical variable associations.
Results: Demographic characteristics of women were found to be comparable between groups. Umbilical arterial potential of hydrogen, partial pressure of oxygen, partial pressure of carbon dioxide, base excess, bicarbonate, birth weight, and APGAR scores were comparable across groups, showing no significant differences ( > 0.05). Groups had similar maternal haemodynamic characteristics and episodes of nausea, vomiting, and chest pain across groups without statistical significance ( > 0.05).
Conclusion: No notable distinction was found between neonatal outcomes and maternal complications between phenylephrine and norepinephrine bolus regimens. Norepinephrine can be used as an alternative to phenylephrine post-spinal hypotension in women undergoing elective caesarean section.
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| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC10993945 | PMC |
| http://dx.doi.org/10.4103/ija.ija_920_23 | DOI Listing |
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Article Synopsis
- The shock index (SI), calculated by heart rate divided by systolic blood pressure, is linked to adverse maternal outcomes, particularly in obstetric cases where SI ≥ 0.9 is noted.
- In this study, researchers analyzed the relationship between baseline SI and hypotension after spinal anesthesia in parturients undergoing non-elective cesarean sections, using logistic regression for data analysis.
- The findings revealed that a higher baseline SI was significantly associated with both post-spinal and post-delivery hypotension, indicating that SI could be a useful metric for predicting these complications in surgery.
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