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ETILEFRINE VS PHENYLEPHRINE FOR HYPOTENSION DURING SPINAL ANESTHESIA FOR CESAREAN SECTION: CLINICAL TRIAL CONTROLLED MULTICENTER RANDOMIZED, DOUBLE BLIND.
Abstract Number: TW-2
Abstract Type: Original Research
Hypotension during spinal anesthesia for cesarean delivery should be minimized, both for maternal safety and comfort, and fetal wellbeing. The use of vasopressors is an effective measure for treatment. The aim of this study is to compare the effect of etilefrine versus phenylephrine for management of this condition in patients with hypotension from spinal anesthesia.
In this multicenter, double-blind study, between August 2009 and November 2010, 196 patients with hypotension during spinal anesthesia for cesarean section were randomized to receive etilefrine or phenylephrine as vasopressor. The primary outcome was the fetal umbilical arterial pH. The secondary outcomes were: fetal acidosis (umbilical arterial pH <7.20), Apgar score at 1 and 5 minutes, need for intubation and admission to neonatal intensive care unit for newborns, and time of hypotension, total dose of vasopressor, requirement of atropine, intravenous fluids volume and incidence of nausea and vomiting for mothers.
98 patients received etilefrine and 98 received phenylephrine. There were no differences in umbilical arterial pH (7.27 vs 7.28, respectively, p = 0.736). The total dose of vasopressor (5.66 vs. 6.51 ml, respectively, P = 0.024) and total time of hypotension (2.78 vs. 3.25 min, respectively, P = 0.021) were lower in the etilefrine group. Other outcomes studied showed no statistically significant difference.
Etilefrine and phenylephrine are equally effective for the treatment of hypotension by spinal anesthesia for cesarean section. This study found no difference in maternal or fetal outcomes.
Anesthesia, Obstetrical, complications; Anesthesia, Spinal; Hypotension; Cesarean Section; Etilefrine; Phenylephrine.