Phenylephrine is an established obstetric vasopressor.
1
However, its use is often associated with a reflex slowing of maternal heart rate
(HR) and a corresponding decrease in cardiac output (CO).
2
As an alternative, we recently investigated norepinephrine (noradrenaline), a potent
alpha-agonist with mild beta-agonist activity which opposes reflex bradycardia.
3
Potentially, this may make norepinephrine a better drug in this setting, but more
data in obstetric patients are required before its use can be generally recommended.
In mid-2015 the author began to use norepinephrine 6 μg/mL routinely as the first-line method of maintaining blood pressure in all parturients
having spinal anaesthesia under his care. The first 12-months’ experience is reported.To read this article in full you will need to make a payment
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References
- Vasopressors in obstetrics: what should we be using?.Curr Opin Anaesthesiol. 2006; 19: 238-243
- The dose-dependent effects of phenylephrine for elective cesarean delivery under spinal anesthesia.Anesth Analg. 2010; 111: 1230-1237
- Randomized double-blinded comparison of norepinephrine and phenylephrine for maintenance of blood pressure during spinal anesthesia for cesarean delivery.Anesthesiology. 2015; 122: 736-745
- Norepinephrine for spinal hypotension during cesarean delivery: another paradigm shift?.Anesthesiology. 2015; 122: 728-730
Article info
Publication history
Published online: January 14, 2017
Accepted:
January 5,
2017
Received in revised form:
January 4,
2017
Received:
December 13,
2016
Identification
Copyright
© 2017 Elsevier Ltd. All rights reserved.
