Abstract：
BACKGROUND: The hemodynamic effects of relatively low-dose epinephrine and phenylephrine infusions during cesarean delivery under spinal anesthesia were compared.
METHODS: This randomized controlled trial included full-term pregnant women who underwent elective cesarean delivery. After spinal anesthesia, participants received either epinephrine (0.03 mcg/kg/min) or phenylephrine (0.4 mcg/kg/min) infusion that continued until 5 min after delivery. The primary outcome was a composite outcome of the occurrence of any of hypotension, hypertension, bradycardia, and/or tachycardia. Neonatal outcomes, including umbilical artery blood gas and Apgar scores, were assessed.
RESULTS: In total, 98 patients in each group were analyzed, and the number of patients with the composite outcome was comparable between the epinephrine and phenylephrine groups (30/98 [31%] vs. 31/98 [32%], respectively; P = 0.877). However, the incidence of hypotension was likely lower in the epinephrine group than in the phenylephrine group (P = 0.066), and the number of hypotensive episodes per patient was lower in the epinephrine group than in the phenylephrine group. On the other hand, the incidence of tachycardia was higher in the epinephrine group than that in the phenylephrine group. The incidence of hypertension was comparable between the two groups and none of the participants developed bradycardia. Neonatal outcomes were comparable between the two groups.
CONCLUSIONS: Epinephrine and phenylephrine infusion produced comparable maternal hemodynamics and neonatal outcomes. Epinephrine was associated with a higher incidence of maternal tachycardia and likely lower incidence of maternal hypotension than phenylephrine. IRB number: MD-245-2022.
BACKGROUND: This study was registered on May 31, 2023 at clinicaltrials.gov registry, NCT05881915, URL: https://classic.
RESULTS: gov/ct2/show/NCT05881915term=NCT05881915&draw=2&rank=1.
METHODS: This randomized controlled trial included full-term pregnant women who underwent elective cesarean delivery. After spinal anesthesia, participants received either epinephrine (0.03 mcg/kg/min) or phenylephrine (0.4 mcg/kg/min) infusion that continued until 5 min after delivery. The primary outcome was a composite outcome of the occurrence of any of hypotension, hypertension, bradycardia, and/or tachycardia. Neonatal outcomes, including umbilical artery blood gas and Apgar scores, were assessed.
RESULTS: In total, 98 patients in each group were analyzed, and the number of patients with the composite outcome was comparable between the epinephrine and phenylephrine groups (30/98 [31%] vs. 31/98 [32%], respectively; P = 0.877). However, the incidence of hypotension was likely lower in the epinephrine group than in the phenylephrine group (P = 0.066), and the number of hypotensive episodes per patient was lower in the epinephrine group than in the phenylephrine group. On the other hand, the incidence of tachycardia was higher in the epinephrine group than that in the phenylephrine group. The incidence of hypertension was comparable between the two groups and none of the participants developed bradycardia. Neonatal outcomes were comparable between the two groups.
CONCLUSIONS: Epinephrine and phenylephrine infusion produced comparable maternal hemodynamics and neonatal outcomes. Epinephrine was associated with a higher incidence of maternal tachycardia and likely lower incidence of maternal hypotension than phenylephrine. IRB number: MD-245-2022.
BACKGROUND: This study was registered on May 31, 2023 at clinicaltrials.gov registry, NCT05881915, URL: https://classic.
RESULTS: gov/ct2/show/NCT05881915term=NCT05881915&draw=2&rank=1.
摘要：
背景：比较了腰麻下剖宫产期间相对低剂量肾上腺素和去氧肾上腺素输注对血流动力学的影响。
方法：这项随机对照试验纳入了接受择期剖宫产的足月孕妇。脊髓麻醉后,参与者接受肾上腺素(0.03mcg/kg/min)或去氧肾上腺素(0.4mcg/kg/min)输注,持续至分娩后5min.主要结局是任何低血压发生的复合结局，高血压,心动过缓,和/或心动过速。新生儿结局,包括脐动脉血气和Apgar评分,被评估。
结果：总计，对每组98例患者进行分析,肾上腺素组和去氧肾上腺素组之间具有复合结局的患者数量相当(30/98[31%]vs.31/98[32%]，分别；P=0.877）。然而,肾上腺素组低血压的发生率可能低于去氧肾上腺素组(P=0.066),肾上腺素组的低血压发作次数低于去氧肾上腺素组.另一方面,肾上腺素组心动过速的发生率高于去氧肾上腺素组。两组之间的高血压发病率相当，没有参与者出现心动过缓。两组新生儿结局具有可比性。
结论：输注肾上腺素和去氧肾上腺素可产生相当的母体血流动力学和新生儿结局。与去氧肾上腺素相比，肾上腺素与母体心动过速的发生率更高，并且可能与母体低血压的发生率更低有关。IRB编号：MD-245-2022。
背景：这项研究于2023年5月31日在clinicaltrials.gov注册表注册，NCT05881915，URL：https://classic。
结果：gov/ct2/show/NCT05881915term=NCT05881915&draw=2&rank=1。
方法：这项随机对照试验纳入了接受择期剖宫产的足月孕妇。脊髓麻醉后,参与者接受肾上腺素(0.03mcg/kg/min)或去氧肾上腺素(0.4mcg/kg/min)输注,持续至分娩后5min.主要结局是任何低血压发生的复合结局，高血压,心动过缓,和/或心动过速。新生儿结局,包括脐动脉血气和Apgar评分,被评估。
结果：总计，对每组98例患者进行分析,肾上腺素组和去氧肾上腺素组之间具有复合结局的患者数量相当(30/98[31%]vs.31/98[32%]，分别；P=0.877）。然而,肾上腺素组低血压的发生率可能低于去氧肾上腺素组(P=0.066),肾上腺素组的低血压发作次数低于去氧肾上腺素组.另一方面,肾上腺素组心动过速的发生率高于去氧肾上腺素组。两组之间的高血压发病率相当，没有参与者出现心动过缓。两组新生儿结局具有可比性。
结论：输注肾上腺素和去氧肾上腺素可产生相当的母体血流动力学和新生儿结局。与去氧肾上腺素相比，肾上腺素与母体心动过速的发生率更高，并且可能与母体低血压的发生率更低有关。IRB编号：MD-245-2022。
背景：这项研究于2023年5月31日在clinicaltrials.gov注册表注册，NCT05881915，URL：https://classic。
结果：gov/ct2/show/NCT05881915term=NCT05881915&draw=2&rank=1。
