ReviewCureus2026
Phenylephrine Versus Noradrenaline for the Prevention and Treatment of Spinal-Induced Hypotension During Caesarean Section: A Literature Review.
Review in Cureus, 2026. 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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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.
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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.
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Authors and funding
3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Spinal anaesthesia is the most commonly used anaesthetic technique for caesarean section due to its rapid onset, reliability, and favourable safety profile. Despite these advantages, spinal-induced hypotension remains a common complication with potential adverse effects on maternal and fetal well-being, including nausea, vomiting, dizziness, reduced cardiac output, and impaired uteroplacental perfusion. Phenylephrine remains the guideline-supported first-line vasopressor for spinal-induced hypotension during caesarean delivery because of its effectiveness in maintaining maternal blood pressure and its favourable fetal acid-base profile, including a lower risk of fetal acidosis compared with ephedrine. However, it may cause reflex bradycardia and reduced maternal cardiac output. Norepinephrine (noradrenaline) has emerged as a promising alternative because its α-adrenergic effects, combined with modest β1 activity, may better preserve maternal heart rate and cardiac output. A narrative literature review was conducted using PubMed/MEDLINE, Scopus, and Google Scholar. Studies were included if they evaluated maternal haemodynamic outcomes, adverse maternal effects, neonatal outcomes, or vasopressor efficacy during caesarean delivery under spinal anaesthesia. Recent trials and meta-analyses suggest that noradrenaline provides comparable efficacy to phenylephrine, with similar neonatal outcomes and potential maternal haemodynamic advantages. However, phenylephrine remains the current guideline-supported first-line agent, while noradrenaline requires further clarification regarding optimal dosing, safety, and routine first-line use. This review evaluates phenylephrine and noradrenaline for both prophylaxis and rescue treatment of spinal-induced hypotension during caesarean section.
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