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Incidence of hypotension is high in parturients after spinal anesthesia. Ephedrine could be used to treat hypotension but lead to lower fetal pH as well. This study is to compare the effects of norepinephrine and ephedrine on hypotension in parturients.
Spinal anesthesia is an accepted technique in elective cesarean sections. However, hypotension, resulted from sympathectomy is a common problem, especially in pregnant women. Prevention of this complication by sympathomimetic agents is of potential clinical significance. Ephedrine could be used to treat hypotension but lead to lower fetal pH, which may be related to worse fetal outcome.Norepinephrine could improve the hypotension to the same extent as phenylephrine. In this study, we tend to compare the effects of norepinephrine and ephedrine on hypotension in parturients and on fetal acid status.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| norepinephrine | Experimental | norepinephrine is injected after spinal anesthesia |
|
| ephedrine | Other | ephedrine is injected after spinal anesthesia |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Norepinephrine | Drug | norepinephrine injection |
|
|
| Measure | Description | Time Frame |
|---|---|---|
| incidence of hypotension | from immediately after spinal anesthesia to 30min after spinal anesthesia |
| Measure | Description | Time Frame |
|---|---|---|
| pH value of fetal arterial blood | just after clamp of the umbilical cord, usually 1min to 10min after start of the surgery | |
| incidence of nausea and vomiting | from immediately after spinal anesthesia to 30min after spinal anesthesia |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Hailong DONG, Prof. | Xijing Hospital | Study Chair |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Xijing Hospital,Fourth Military Medical University | Xi'an | Shaanxi | 710032 | China |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 25654435 | Background | Carvalho B, Dyer RA. Norepinephrine for Spinal Hypotension during Cesarean Delivery: Another Paradigm Shift? Anesthesiology. 2015 Apr;122(4):728-30. doi: 10.1097/ALN.0000000000000602. No abstract available. | |
| 25649721 | Background | Moslemi F, Rasooli S. Comparison of Prophylactic Infusion of Phenylephrine with Ephedrine for Prevention of Hypotension in Elective Cesarean Section under Spinal Anesthesi: A Randomized Clinical Trial. Iran J Med Sci. 2015 Jan;40(1):19-26. |
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| ID | Term |
|---|---|
| D007022 | Hypotension |
| ID | Term |
|---|---|
| D014652 | Vascular Diseases |
| D002318 | Cardiovascular Diseases |
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| ID | Term |
|---|---|
| D009638 | Norepinephrine |
| D004809 | Ephedrine |
| ID | Term |
|---|---|
| D004983 | Ethanolamines |
| D000605 | Amino Alcohols |
| D000438 | Alcohols |
| D009930 | Organic Chemicals |
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| Ephedrine | Drug | Ephedrine injection |
|
|
| incidence of dizzy | from immediately after spinal anesthesia to 30min after spinal anesthesia |
| incidence of chest congestion | from immediately after spinal anesthesia to 30min after spinal anesthesia |
| fetal arterial partial pressure of oxygen | just after clamp of the umbilical cord, usually 1min to 10min after start of the surgery |
| arterial base excess of fetal arterial blood | just after clamp of the umbilical cord, usually 1min to 10min after start of the surgery |
| lowest neonatal cerebral oxygen saturation | from clamp of the umbilical cord to 10 min later, 10min in total |
| lactate level of fetal arterial blood | just after clamp of the umbilical cord, usually 1min to 10min after start of the surgery |
| number of rescue vasoactive agent | from immediately after spinal anesthesia to 30min after spinal anesthesia |
| incidence of bradycardia | from immediately after spinal anesthesia to 30min after spinal anesthesia |
| incidence of dyspnea | from immediately after spinal anesthesia to 30min after spinal anesthesia |
| Apgar scores of the neonates | The Apgar score is a method to quickly summarize the health of newborn children.It is determined by evaluating the newborn baby on five simple criteria(Appearance, Pulse, Grimace, Activity, Respiration) on a scale from zero to two, then summing up the five values thus obtained. The resulting Apgar score ranges from zero to 10. Scores 7 and above are generally normal; 4 to 6, fairly low; and 3 and below are generally regarded as critically low and cause for immediate resuscitative efforts | from clamp of umbilical cord to 1min after clamping |
| Apgar scores of the neonates | The Apgar score is a method to quickly summarize the health of newborn children.It is determined by evaluating the newborn baby on five simple criteria(Appearance, Pulse, Grimace, Activity, Respiration) on a scale from zero to two, then summing up the five values thus obtained. The resulting Apgar score ranges from zero to 10. Scores 7 and above are generally normal; 4 to 6, fairly low; and 3 and below are generally regarded as critically low and cause for immediate resuscitative efforts | from clamp of umbilical cord to 5min after clamping |
| 23793313 | Background | Mitra JK, Roy J, Bhattacharyya P, Yunus M, Lyngdoh NM. Changing trends in the management of hypotension following spinal anesthesia in cesarean section. J Postgrad Med. 2013 Apr-Jun;59(2):121-6. doi: 10.4103/0022-3859.113840. |
| 33661141 | Derived | Fan QQ, Wang YH, Fu JW, Dong HL, Yang MP, Liu DD, Jiang XF, Wu ZX, Xiong LZ, Lu ZH. Comparison of two vasopressor protocols for preventing hypotension post-spinal anesthesia during cesarean section: a randomized controlled trial. Chin Med J (Engl). 2021 Mar 4;134(7):792-799. doi: 10.1097/CM9.0000000000001404. |
| D000588 |
| Amines |
| D015306 | Biogenic Monoamines |
| D001679 | Biogenic Amines |
| D002395 | Catecholamines |
| D002396 | Catechols |
| D010636 | Phenols |
| D001555 | Benzene Derivatives |
| D006841 | Hydrocarbons, Aromatic |
| D006844 | Hydrocarbons, Cyclic |
| D006838 | Hydrocarbons |
| D011412 | Propanolamines |
| D020005 | Propanols |
| D010627 | Phenethylamines |
| D005021 | Ethylamines |