Randomized Double-blind Comparison of Bolus Phenylephrine or Ephedrine for Treatment of Hypotension in Women With Preeclampsia Undergoing Caesarean Section

Abstract

(Anaesthesia. 2018;73:839–846) Preeclampsia is a common complication of pregnancy. In the past, anesthesiologists had sometimes avoided the use of spinal anesthesia in parturients with preeclampsis due to concerns about spinal-induced hypotension leading to inadequate uteroplacental perfusion. However, more recent studies have shown spinal anesthesia to be a safe technique in preeclamptic women as the hypotension associated with it is less severe than that experienced by normotensive parturients and is easily treated. However, effective treatment of postspinal hypotension remains an important component of anesthetic management. While phenylephrine has become the vasopressor of choice for treatment of hypotension in healthy women undergoing cesarean section due to the lower risk of fetal acidosis, the preferred vasopressor for preeclamptic women remains unclear. This randomized, double blind study was performed to compare the effects of phenylephrine versus ephedrine for the treatment of spinal-induced hypotension in preeclamptic women undergoing cesarean section.