ArticleCureus2025
Estimation of the Effective Dose of Phenylephrine Infusion for Preventing Spinal Anesthesia-Induced Hypotension in Elective Cesarean Deliveries: A Randomized Controlled Trial.
Article in Cureus, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
introductionSpinal anesthesia for cesarean delivery may be associated with hypotension and fetal acidosis. Phenylephrine, an α1 adrenergic receptor agonist, is effective in treating hypotension with the benefit of less placental transfer.
objectiveThe objective of this study was to determine the optimum dose of prophylactic phenylephrine infusion for preventing spinal anesthesia-induced hypotension in women undergoing elective cesarean delivery and to assess its effect on fetal outcomes, as measured by APGAR scores at 1, 5, and 10 minutes. METHODOLOGY: Two hundred and forty patients were included in this double-blinded study. Women undergoing elective cesarean section were preloaded with crystalloids and then randomly allocated to receive prophylactic Phenylephrine infusion at either 25, 50, 75, or 100 µg/minute immediately after spinal anesthesia (Groups A, B, C, and D, respectively). Maternal hemodynamic parameters, total dose of phenylephrine used, APGAR score, and incidence of maternal complications like reactive hypertension, bradycardia, nausea, and vomiting, as well as fetal complications like fetal acidosis, were noted. The study was registered with the Clinical Trials Registry of India (CTRI/2019/07/020231, dated July 17, 2019) Results: Demographic parameters were comparable across all four groups (
conclusionsWe concluded that starting prophylactic Phenylephrine infusion at 50 µg/minute immediately after spinal anesthesia was an effective and simple method of reducing the incidence, frequency, and magnitude of hypotension in elective cesarean section with no adverse effect on neonatal outcome.
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