The Efficacy and Safety of Norepinephrine and Its Feasibility as a Replacement for Phenylephrine to Manage Maternal Hypotension during Elective Cesarean Delivery under Spinal Anesthesia
Joint Authors
Wang, Xian
Shen, Xiaofeng
Liu, Shijiang
Yang, Jianjun
Xu, Shiqin
Source
Issue
Vol. 2018, Issue 2018 (31 Dec. 2018), pp.1-14, 14 p.
Publisher
Hindawi Publishing Corporation
Publication Date
2018-12-31
Country of Publication
Egypt
No. of Pages
14
Main Subjects
Abstract EN
Maternal hypotension commonly occurs during spinal anesthesia for cesarean delivery, with a decrease of systemic vascular resistance recognized as a significant contributor.
Accordingly, counteracting this effect with a vasopressor that constricts arterial vessels is appropriate, and the pure α-adrenergic receptor agonist phenylephrine is the current gold standard for treatment.
However, phenylephrine is associated with dose-dependent reflex bradycardia and decreased cardiac output, which can endanger the mother and fetus in certain circumstances.
In recent years, the older, traditional vasopressor norepinephrine has attracted increasing attention owing to its mild β-adrenergic effects in addition to its α-adrenergic effects.
We search available literature for papers directly related to norepinephrine application in spinal anesthesia for elective cesarean delivery.
Nine reports were found for norepinephrine use either alone or compared to phenylephrine.
Results show that norepinephrine efficacy in rescuing maternal hypotension is similar to that of phenylephrine without obvious maternal or neonatal adverse outcomes, and with a lower incidence of bradycardia and greater cardiac output.
In addition, either computer-controlled closed loop feedback infusion or manually-controlled variable-rate infusion of norepinephrine provides more precise blood pressure management than equipotent phenylephrine infusion or norepinephrine bolus.
Thus, based on the limited available literature, norepinephrine appears to be a promising alternative to phenylephrine; however, before routine application begins, more favorable high-quality studies are warranted.
American Psychological Association (APA)
Wang, Xian& Shen, Xiaofeng& Liu, Shijiang& Yang, Jianjun& Xu, Shiqin. 2018. The Efficacy and Safety of Norepinephrine and Its Feasibility as a Replacement for Phenylephrine to Manage Maternal Hypotension during Elective Cesarean Delivery under Spinal Anesthesia. BioMed Research International،Vol. 2018, no. 2018, pp.1-14.
https://search.emarefa.net/detail/BIM-1124715
Modern Language Association (MLA)
Wang, Xian…[et al.]. The Efficacy and Safety of Norepinephrine and Its Feasibility as a Replacement for Phenylephrine to Manage Maternal Hypotension during Elective Cesarean Delivery under Spinal Anesthesia. BioMed Research International No. 2018 (2018), pp.1-14.
https://search.emarefa.net/detail/BIM-1124715
American Medical Association (AMA)
Wang, Xian& Shen, Xiaofeng& Liu, Shijiang& Yang, Jianjun& Xu, Shiqin. The Efficacy and Safety of Norepinephrine and Its Feasibility as a Replacement for Phenylephrine to Manage Maternal Hypotension during Elective Cesarean Delivery under Spinal Anesthesia. BioMed Research International. 2018. Vol. 2018, no. 2018, pp.1-14.
https://search.emarefa.net/detail/BIM-1124715
Data Type
Journal Articles
Language
English
Notes
Includes bibliographical references
Record ID
BIM-1124715