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A Randomized Comparison of Bolus Phenylephrine and Ephedrine for the Management of Spinal Hypotension in Patients With Severe Preeclampsia and Fetal Compromise

Dyer, R.A.; Emmanuel, A.; Adams, S.C.; Lombard, C.J.; Arcache, M.J.; Vorster, A.; Wong, C.A.; Higgins, N.; Reed, A.R.; James, M.F.; Joolay, Y.; Schulein, S.; van Dyk, D.

doi: 10.1097/01.aoa.0000547271.20090.30
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(Int J Obstet Anesth. 2018;33:23–31)

Ephedrine and phenylephrine have both been used to prevent and treat the spinal hypotension that is common during cesarean delivery. When compared with phenylephrine, ephedrine is associated with greater fetal acidosis in healthy parturients. However, there are limited data regarding the relative efficacy of these 2 drugs for managing hypotension in women with fetal compromise. The present trial examined the effects of bolus ephedrine versus phenylephrine for the treatment of spinal hypotension in women with severe preeclampsia and a nonreassuring fetal heart tracing who were undergoing cesarean delivery.

Department of Anaesthesia and Perioperative Medicine, University of Cape Town, Cape Town, South Africa

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