Neonatal outcomes following prophylactic administration of phenylephrine or noradrenaline in women undergoing scheduled caesarean delivery

Abstract

Foetal acidosis is a well established predictor of neonatal outcome and is associated with increased morbidity and mortality. Noradrenaline, despite providing better maternal haemodynamic stability than phenylephrine during caesarean delivery, creates concerns regarding its deleterious effects on neonates. This study compares the incidence of foetal acidosis and umbilical artery base excess during prophylactic noradrenaline and phenylephrine infusion in elective caesarean section.

Reply to: phenylephrine versus noradrenaline for caesarean delivery under spinal anaesthesia

“…We appreciate the interest by Lee et al 1 in our article “Neonatal outcomes following prophylactic administration of phenylephrine or noradrenaline in women undergoing scheduled caesarean delivery: A randomised clinical trial.” 2 First of all the authors raised the concern of higher dose of P as compared to N. In our study, group P received 60 μg of P as a bolus and then a continuous intravenous infusion at 100 μg min –1 . In group N, 6 μg of N was injected as a bolus, followed by infusion at 5 μg min –1 .…”

Phenylephrine versus noradrenaline for caesarean delivery under spinal anaesthesia

“…We appreciate the interest by Lee et al 1 in our article ''Neonatal outcomes following prophylactic administration of phenylephrine or noradrenaline in women undergoing scheduled caesarean delivery: A randomised clinical trial.'' 2 First of all the authors raised the concern of higher dose of P as compared to N. In our study, group P received 60 mg of P as a bolus and then a continuous intravenous infusion at 100 mg min -1 .…”

“…We read with great interest the study by Singh et al 1 comparing neonatal outcomes following prophylactic administration of intravenous phenylephrine (P) or intravenous noradrenaline (N) in women undergoing scheduled caesarean delivery during spinal anaesthesia. In this double-blind randomised clinical trial, 100 full-term, non-labouring pregnant women were randomly divided into groups P and N. After cerebrospinal fluid appeared at the hub of the spinal needle during spinal anaesthesia, group P was injected with 60 μg of P intravenous as a bolus, and then started on continuous intravenous infusion of P intravenous at 100 μg min −1 .…”

Norepinephrine versus phenylephrine for managing maternal hypotension during cesarean delivery under spinal anesthesia: a meta-analysis of maternal and neonatal outcomes

“…Norepinephrine; Phenylephrine; Maternal hypotension; Caesarean delivery; Spinal anesthesia norepinephrine adversely affected fetal acid-base status less frequently [13]. Moreover, the effectiveness of norepinephrine and phenylephrine in managing maternal hypotension during cesarean sections was recently evaluated in randomized controlled trials using neonatal outcomes as the primary research indicator [14][15][16].…”