The Effect of Phenylephrine Infusion on Maternal Hemodynamic Changes During Spinal Anesthesia for Cesarean Delivery

Shafeinia, Amineh; Ghaed, Mohammad Ali; Nikoubakht, Nasim

doi:10.5812/aapm.99094

Cited by 10 publications

(8 citation statements)

References 20 publications

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“…Moreover, a spinal block technique can take a shorter time than an epidural block (3). Some studies mentioned that spinal analgesia not only can be applied more easily but also is faster, less expensive, and more effective than epidural analgesia (4)(5)(6)(7)(8)(9)(10)(11). Administration of opioid drugs in neuraxial blocks, which do not affect the sympathetic activity, along with local anesthetics, is a common technique to avoid negative consequences such as hypotension in these techniques (12)(13)(14)(15)(16).…”

Section: Introductionmentioning

confidence: 99%

Effectiveness of Spinal Analgesia for Labor Pain Compared with Epidural Analgesia

Rahmati

Shahriari

et al. 2021

Anesth Pain Med

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Objectives: This study aimed to compare the analgesic effect of single-dose spinal versus epidural analgesia for labor pain to verify if applying a single dose spinal analgesia is an efficient technique for labor pain management as an alternative for epidural analgesia. Methods: A total of 128 women in the active phase of labor were randomly allocated into two groups of spinal analgesia (n = 64) and epidural analgesia (n = 64). The latter received a bolus dose of 16 mL of 0.125% bupivacaine and 50 μg fentanyl and repeated 5 - 10 mL of bolus dose. The former received 2.5 mg hyperbaric bupivacaine plus 50μg fentanyl. Pain intensity was measured using the visual analog scale (VAS). The duration of analgesia, mode of delivery, the duration of labor, side effects, and maternal satisfaction were also compared. Results: There were no significant differences in the rate of cesarean section, duration of labor, postpartum hemorrhage, and the frequency of the fetal heart deceleration until 30 min after analgesia between the two groups. Measured pain after 30 (P = 0.0001) and 90 min (P = 0.01) was significantly lower in the spinal group than the epidural group. However, there was no significant difference between the spinal and epidural groups concerning the VAS scores at 150, 210, and 270 minutes. Maternal satisfaction was higher in the spinal group (P = 0.002). The mean duration of analgesia was longer in the spinal group than the epidural group (P = 0.0001). Conclusions: According to the findings, single-dose spinal analgesia, compared to epidural analgesia, is a safe, fast, and efficient technique for labor analgesia, which can be easily performed. In addition, it provides a high satisfaction level in the parturient.

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Section: Introductionmentioning

confidence: 99%

Effectiveness of Spinal Analgesia for Labor Pain Compared with Epidural Analgesia

Rahmati

Shahriari

et al. 2021

Anesth Pain Med

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“…This issue was more prominent when another author added glucose to the crystalloid solution (15). In contrast, another study has revealed that infusion of phenylephrine to prevent overt either hypotension or bradycardia was associated with better symptom (nausea and vomiting) control and also resulted in favorable neonatal blood gas outcomes (16). Although we used crystalloid for all participants, the latter finding showed that the effect of other parameters should be kept in mind.…”

Section: Discussionmentioning

confidence: 91%

Magnesium Sulfate and Clonidine; Effects on Hemodynamic Factors and Depth of General Anesthesia in Cesarean Section

et al. 2020

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Background: Making stable hemodynamic and also durable unawareness is a daily challenge in the setting of general anesthesia in women who undergo surgical delivery of neonate and have limitations to receive opioids derivatives. Objectives: We aimed to evaluate the effects of magnesium sulfate and clonidine on hemodynamic changes and depth of anesthesia and in mentioned mothers and also in neonatal APGAR index. Methods: Current randomized, double-blind controlled trial study was conducted among a total of 360 pregnant females (38 - 41 weeks of gestation) who underwent elective cesarean section. Participants were randomly divided into three drug-receiving groups (equal 120 members): magnesium sulfate (30 mg/kg), clonidine (3 µg/kg), and placebo (0.9% NaCl). Patients’ blood pressure, heart rate, cerebral state index (CSI) in specific time zones, and also late 24-hour recall were recorded. The CSI is an electroencephalographic monitoring method helping to assess the depth of anesthesia. Neonatal parameters, including APGAR score and umbilical venous blood sampling, were measured. Results: Mean patients’ age was 28 ± 4.5. A significant decreasing and stabilizing effect of magnesium sulfate and clonidine on hemodynamic parameters (blood pressure and heart rate) was revealed (P < 0.001). Evidence implied on deeper anesthesia (lower CSI) among drug receivers comparing to placebo (P < 0.001). None of the participants experienced a late 24-hour recall postoperatively. All neonates were healthy, and no decrease was reported in APGAR score at minutes 1 and 5. Umbilical blood gas analysis showed no signs of acidosis and/or hypoxemia. Conclusions: Adjuvant administration of either magnesium sulfate or clonidine is associated with hemodynamic stability and favorable unawareness in the setting of elective surgical delivery.

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“…The study results showed that phenylephrine compared to saline had no effect on patients' hypotension and tachycardia, but had a significant effect on patients' heart rate [20], which is consistent with the results of this study. In a study by Shafeinia et al on 116 patients in the phenylephrine and normal saline control groups, it was shown that phenylephrine reduced some of the complications of pregnant women undergoing cesarean section, such as hypotension (systolic and diastolic), arterial hypertension, nausea and vomiting [17]. Also in a study by Nikooseresht et al, 120 patients undergoing cesarean section were divided into 3 groups: Therapeutic Bolus, Prophylactic Bolus and Prophylactic Infusion.…”

Section: Discussionmentioning

confidence: 99%

“…Demographic information checklist including information on age, gender, height, weight, gestational age, blood pressure (systolic and diastolic), heart rate, and Apgar score (first and fifth minutes) was used. The patients' nausea was also divided into 4 categories without nausea (score zero), low nausea (score one), high nausea (score 2) and vomiting [17].…”

Section: Data Gatheringmentioning

confidence: 99%

Investigation the Effects of Phenylephrine on Oxytocin-Induced Hemodynamic Changes in Women Undergoing Cesarean Section

Nouri

bakhtar

2021

JPRI

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Pregnancy is considered as one of the most important events in every woman's life, which is not a pleasant event for all women, and in cases where the stages are not managed properly, it can cause a lot of stress on the mother and her family. For this reason, the present study was conducted to investigate the effect of phenylephrine on oxytocin-induced hemodynamic changes. This study was conducted on a group of pregnant women referred to Ayatollah Taleghani Hospital in Ilam and those undergoing cesarean section were included in the study. The objectives of the study explained to the women participating in the study, whether the participation was voluntary or not to participate in the intervention, compliance with the Helsinki and Belmont Declaration, and confidentiality of information. The women included in the study were randomly assigned to experimental and control groups. The checklists of the researchers were completed by observing and asking the patients from the time the patient entered the hospital until the end of the surgery. The variables expected by the researchers were evaluated before the intervention and 2, 4, 6, 8, 10 and 12 minutes after the intervention. In the experimental group, 12 (30%) patients had no nausea, 18 (45%) patients had low nausea, 8 (20%) patients had moderate nausea and 2 (5%) patients had severe nausea. While in the control group, 5 (12.5%) patients had no nausea, 13 (32.5%) patients had low nausea, 14 (35%) patients had moderate nausea and 8 (20%) patients had severe nausea. Also, a significant difference was between in the experimental and control groups in terms of nausea (P = 0.02). The study results showed that using phenylephrine can be effective on improving blood pressure, heart rate, nausea and vomiting in patients, which for this reason it is recommended to use this drug to improve the health of women undergoing cesarean section.

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The Effect of Phenylephrine Infusion on Maternal Hemodynamic Changes During Spinal Anesthesia for Cesarean Delivery

Cited by 10 publications

References 20 publications

Effectiveness of Spinal Analgesia for Labor Pain Compared with Epidural Analgesia

Effectiveness of Spinal Analgesia for Labor Pain Compared with Epidural Analgesia

Magnesium Sulfate and Clonidine; Effects on Hemodynamic Factors and Depth of General Anesthesia in Cesarean Section

Investigation the Effects of Phenylephrine on Oxytocin-Induced Hemodynamic Changes in Women Undergoing Cesarean Section

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