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The effects of a loading dose of phenylephrine for the prevention of maternal hypotension under spinal anesthesia for Cesarean section
Anesth Pain Med 2018;13(1):34-9
Published online January 31, 2018
© 2018 Korean Society of Anesthesiologists.

Sang Hi Park1, Joo Yong Lee1, and Sang Tae Kim1,2
1Department of Anesthesiology and Pain Medicine, Chungbuk National University Hospital, 2Department of Anesthesiology and Pain Medicine, Chungbuk National University College of Medicine, Cheongju, Korea
Correspondence to: Sang Tae Kim, M.D., Ph.D.
Department of Anesthesiology and Pain Medicine, Chungbuk National University Hospital, Chungbuk National University College of Medicine, 776 1sunhwan-ro, Seowon-gu, Cheongju 28644, Korea
Tel: 82-43-269-6237
Fax: 82-43-272-0264
E-mail: kimst@chungbuk.ac.kr
ORCID
http://orcid.org/0000-0001-9315-2107
Received September 8, 2017; Revised November 10, 2017; Accepted November 23, 2017.
cc This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Background: Phenylephrine is frequently used for the prevention and treatment of maternal hypotension in patients undergoing Cesarean section. But there are limited studies about the prophylactic effect on maternal hypotension with a loading dose, followed by a continuous infusion of phenylephrine. Therefore, we investigated the additional effect of a loading dose infusion of phenylephrine on the prevention of maternal hypotension, and compared it to a continuous infusion of phenylephrine without a loading dose.
Methods: Following spinal anesthesia, sixty-four patients were randomly assigned to one of two groups according to the phenylephrine administration regimen: group L (n = 32; loading dose [200 µg/min] just before continuous infusion [20 µg/min]) and group C (n = 32; continuous infusion [20 µg/min] without a loading dose). We measured the blood pressure and heart rate, and assessed the incidence of hypotension, nausea, vomiting, dosage of used rescue drugs and fetal parameters.
Results: At 2, 4 minutes after administration of phenylephrine, group L showed a higher systolic blood pressure and lower heart rate than group C. However, there were no significant differences in the incidence of hypotension, nausea, vomiting and the dosage of used rescue drugs. There were no significant differences in the fetal parameters such as Apgar scores and umbilical pH.
Conclusions: The loading dose infusion of phenylephrine had no beneficial positive effect on the prevention of maternal hypotension.
Key Words : Cesarean section, Hypotension, Phenylephrine.


January 2018, 13 (1)
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