Evidence map›Paper›PMID 38789602›Full record

Trial reportJournal of anesthesia2024

Epinephrine vs. phenylephrine infusion for prophylaxis against maternal hypotension after spinal anesthesia for cesarean delivery: a randomized controlled trial.

Yasmin S Hassabelnaby, Ahmed M Hasanin, Mohamed Shamardal, Maha Mostafa, Rana M Zaki, Mona Elsherbiny, Sherin Refaat

Registry-linked trialAbstract readRandomized Controlled TrialComparative Study
PubMed Publisher
In one paragraph

Trial report in Journal of anesthesia, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05881915 (Epinephrine Versus Phenylephrine Infusion for Prophylaxis Against Maternal Hypotension After Spinal Anesthesia for Cesarean Delivery), which is not on this map. Cited by 10 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
10citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT05881915 nacompletednot on this map

Epinephrine Versus Phenylephrine Infusion for Prophylaxis Against Maternal Hypotension After Spinal Anesthesia for Cesarean Delivery: a Randomized Controlled Trial.

TypeinterventionalSponsorCairo UniversityRan2023 to 2023Enrolled196ConditionsHypotension During SurgeryArmsPhenylephrine, Epinephrine
3 · Its place in the literature

Who cites it

10 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Review
  3. Review
  4. Review
  5. Article
  6. Article
  7. High spinal block in cesarean section.Journal of anesthesia · 2024
    Article
  8. Article
  9. Article
  10. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

7 authors.

Yasmin S HassabelnabyDepartment of Anesthesia and Critical Care Medicine, Cairo University, Cairo, Egypt.
Ahmed M HasaninDepartment of Anesthesia and Critical Care Medicine, Cairo University, Cairo, Egypt. ahmedmohamedhasanin@gmail.com.ORCID 0000-0001-9947-5863
Mohamed ShamardalDepartment of Anesthesia and Critical Care Medicine, Cairo University, Cairo, Egypt.
Maha MostafaDepartment of Anesthesia and Critical Care Medicine, Cairo University, Cairo, Egypt.
Rana M ZakiDepartment of Anesthesia and Critical Care Medicine, Cairo University, Cairo, Egypt.
Mona ElsherbinyDepartment of Anesthesia and Critical Care Medicine, Cairo University, Cairo, Egypt.
Sherin RefaatDepartment of Anesthesia and Critical Care Medicine, Cairo University, Cairo, Egypt.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe hemodynamic effects of relatively low-dose epinephrine and phenylephrine infusions during cesarean delivery under spinal anesthesia were compared.

methodsThis randomized controlled trial included full-term pregnant women who underwent elective cesarean delivery. After spinal anesthesia, participants received either epinephrine (0.03 mcg/kg/min) or phenylephrine (0.4 mcg/kg/min) infusion that continued until 5 min after delivery. The primary outcome was a composite outcome of the occurrence of any of hypotension, hypertension, bradycardia, and/or tachycardia. Neonatal outcomes, including umbilical artery blood gas and Apgar scores, were assessed.

resultsIn total, 98 patients in each group were analyzed, and the number of patients with the composite outcome was comparable between the epinephrine and phenylephrine groups (30/98 [31%] vs. 31/98 [32%], respectively; P = 0.877). However, the incidence of hypotension was likely lower in the epinephrine group than in the phenylephrine group (P = 0.066), and the number of hypotensive episodes per patient was lower in the epinephrine group than in the phenylephrine group. On the other hand, the incidence of tachycardia was higher in the epinephrine group than that in the phenylephrine group. The incidence of hypertension was comparable between the two groups and none of the participants developed bradycardia. Neonatal outcomes were comparable between the two groups.

conclusionsEpinephrine and phenylephrine infusion produced comparable maternal hemodynamics and neonatal outcomes. Epinephrine was associated with a higher incidence of maternal tachycardia and likely lower incidence of maternal hypotension than phenylephrine. IRB number: MD-245-2022. CLINICAL

trial registrationThis study was registered on May 31, 2023 at clinicaltrials.gov registry, NCT05881915, URL: https://classic. CLINICALTRIALS: gov/ct2/show/NCT05881915term=NCT05881915&draw=2&rank=1.

Indexed as

Anesthesia, ObstetricalAnesthesia, SpinalCesarean SectionEpinephrineHypotensionPhenylephrineVasoconstrictor AgentsAdultFemaleHumansInfant, NewbornInfusions, IntravenousPregnancyEpinephrinePhenylephrineVasoconstrictor AgentsCesarean deliveryEpinephrineHypotensionPhenylephrineSpinal anesthesia

Identifiers

PMID38789602

What OpenQuestion holds

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.