A Prospective Single-Center Brazilian Study Investigating the Efficacy and Safety of Prophylactic Phenylephrine Infusion for the Management of Hypotension During Cesarean Section Under Spinal Anesthesia
BackgroundMaternal hypotension occurs in up to 80% of parturients during cesarean section (CS) under spinal anesthesia. Phenylephrine, a direct-acting α-1 agonist, has been widely recommended for the prevention of hypotension. We evaluated the efficacy and safety of phenylephrine infusion to prevent...
Gespeichert in:
| Veröffentlicht in: | Curēus (Palo Alto, CA) CA), 2023-07, Vol.15 (7), p.e42156-e42156 |
|---|---|
| Hauptverfasser: | , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | e42156 |
|---|---|
| container_issue | 7 |
| container_start_page | e42156 |
| container_title | Curēus (Palo Alto, CA) |
| container_volume | 15 |
| creator | Benevides, Marcio L Andrade, Breno Wilson B Zambardino, Henry Manfried D Benevides, Marco Antonio M |
| description | BackgroundMaternal hypotension occurs in up to 80% of parturients during cesarean section (CS) under spinal anesthesia. Phenylephrine, a direct-acting α-1 agonist, has been widely recommended for the prevention of hypotension. We evaluated the efficacy and safety of phenylephrine infusion to prevent hypotension in obese and non-obese patients during cesarean section.MethodsOne hundred forty-one patients were included in this single-arm study. Patients received prophylactic phenylephrine infusion at a rate of 50 μg/min-1 immediately after spinal local anesthetic injection until delivery. Hypotension was defined as a systolic blood pressure |
| doi_str_mv | 10.7759/cureus.42156 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_10438977</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2854348598</sourcerecordid><originalsourceid>FETCH-LOGICAL-c277t-700001c1e2f92957906a2a3ee656e313d91198f6bbf66c383ebf75bd46e27d273</originalsourceid><addsrcrecordid>eNpdkstq3DAUhk1poSHNrg8g6KaLOtXFtqxVmU5zg5QGplkLWT4aK3gkV7IH3EfMU0WeCSXpSkL69Z3voJNlHwk-57wUX_UUYIrnBSVl9SY7oaSq85rUxdsX-_fZWYwPGGOCOcUcn2SPK3QXfBxAj3YPaGPdtod8DW6EgL4H9df2Vjm0Gad2RjduD3G0WzWmGBo7QBfGWK30jJRr0UYZGGfkzYIcurlXCarRXQdu7mHognWQGGaK1jtkfDggfiqntrBLFZeX1_PgR3CHxI8pLHXWEFWARWKRTOf3rk1ym8E61aOVS0odRKs-ZO-M6iOcPa-n2f3lxe_1dX776-pmvbrNNeV8zDle-tcEqBFUlFzgSlHFAKqyAkZYKwgRtamaxlSVZjWDxvCyaYsKKG8pZ6fZtyN3mJodtDqZB9XLIdidCrP0ysrXN852cuv3kuCC1YIvhM_PhOD_TMlf7mzU0PfKgZ-ipHVZsKIuRZ2in_6LPvgppMYPKVEIwplIqS_HlE5_GQOYfzYEy2U65HE65GE62BP1f7O6</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2859491739</pqid></control><display><type>article</type><title>A Prospective Single-Center Brazilian Study Investigating the Efficacy and Safety of Prophylactic Phenylephrine Infusion for the Management of Hypotension During Cesarean Section Under Spinal Anesthesia</title><source>PubMed Central Open Access</source><source>PubMed Central</source><creator>Benevides, Marcio L ; Andrade, Breno Wilson B ; Zambardino, Henry Manfried D ; Benevides, Marco Antonio M</creator><creatorcontrib>Benevides, Marcio L ; Andrade, Breno Wilson B ; Zambardino, Henry Manfried D ; Benevides, Marco Antonio M</creatorcontrib><description><![CDATA[BackgroundMaternal hypotension occurs in up to 80% of parturients during cesarean section (CS) under spinal anesthesia. Phenylephrine, a direct-acting α-1 agonist, has been widely recommended for the prevention of hypotension. We evaluated the efficacy and safety of phenylephrine infusion to prevent hypotension in obese and non-obese patients during cesarean section.MethodsOne hundred forty-one patients were included in this single-arm study. Patients received prophylactic phenylephrine infusion at a rate of 50 μg/min-1 immediately after spinal local anesthetic injection until delivery. Hypotension was defined as a systolic blood pressure <100 mmHg or <20% of baseline. The primary outcome was the incidence of hypotension.ResultsThe incidence of hypotension was 17%. The median and interquartile range (IQR) of the number of hypotensive episodes was 0 (0-0). It was observed that 79.1% of the patients had hypotension in the first six minutes. Reactive hypertension and bradycardia occurred in 20.5 and 12.7% of the patients, respectively. In addition, there was a higher incidence of bradycardia in pregnant women with a body index mass of < 30 kg/m-2. Patients with baseline systolic blood pressure <120 mmHg had a threefold increased risk of hypotension. The incidence of nausea and vomiting was 13.4 and 2.8%, respectively. The incidence of an Apgar score <7 at the first minute was 2.8%, and no neonates presented an Apgar score <7 at the fifth minute. A pH of <7.2 occurred in 6.3% of the neonates. All neonates had no sequelae and were discharged together with their mothers.ConclusionThe prophylactic infusion of phenylephrine 50 μg/min-1 is safe and demonstrates efficacy in reducing maternal hypotension providing adequate maternal hemodynamic stability during CS under spinal anesthesia.]]></description><identifier>ISSN: 2168-8184</identifier><identifier>EISSN: 2168-8184</identifier><identifier>DOI: 10.7759/cureus.42156</identifier><language>eng</language><publisher>Palo Alto: Cureus Inc</publisher><subject>Acidosis ; Anesthesiology ; Apgar score ; Blood pressure ; Body mass index ; Cardiac arrhythmia ; Cesarean section ; Data analysis ; General anesthesia ; Gestational age ; GLP-1 receptor agonists ; Heart rate ; Hypertension ; Hypotension ; Medical personnel ; Nausea ; Obstetrics/Gynecology ; Patients ; Uterus ; Vomiting</subject><ispartof>Curēus (Palo Alto, CA), 2023-07, Vol.15 (7), p.e42156-e42156</ispartof><rights>Copyright © 2023, Benevides et al. This work is published under https://creativecommons.org/licenses/by/3.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>Copyright © 2023, Benevides et al. 2023 Benevides et al.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c277t-700001c1e2f92957906a2a3ee656e313d91198f6bbf66c383ebf75bd46e27d273</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC10438977/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC10438977/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,885,27923,27924,53790,53792</link.rule.ids></links><search><creatorcontrib>Benevides, Marcio L</creatorcontrib><creatorcontrib>Andrade, Breno Wilson B</creatorcontrib><creatorcontrib>Zambardino, Henry Manfried D</creatorcontrib><creatorcontrib>Benevides, Marco Antonio M</creatorcontrib><title>A Prospective Single-Center Brazilian Study Investigating the Efficacy and Safety of Prophylactic Phenylephrine Infusion for the Management of Hypotension During Cesarean Section Under Spinal Anesthesia</title><title>Curēus (Palo Alto, CA)</title><description><![CDATA[BackgroundMaternal hypotension occurs in up to 80% of parturients during cesarean section (CS) under spinal anesthesia. Phenylephrine, a direct-acting α-1 agonist, has been widely recommended for the prevention of hypotension. We evaluated the efficacy and safety of phenylephrine infusion to prevent hypotension in obese and non-obese patients during cesarean section.MethodsOne hundred forty-one patients were included in this single-arm study. Patients received prophylactic phenylephrine infusion at a rate of 50 μg/min-1 immediately after spinal local anesthetic injection until delivery. Hypotension was defined as a systolic blood pressure <100 mmHg or <20% of baseline. The primary outcome was the incidence of hypotension.ResultsThe incidence of hypotension was 17%. The median and interquartile range (IQR) of the number of hypotensive episodes was 0 (0-0). It was observed that 79.1% of the patients had hypotension in the first six minutes. Reactive hypertension and bradycardia occurred in 20.5 and 12.7% of the patients, respectively. In addition, there was a higher incidence of bradycardia in pregnant women with a body index mass of < 30 kg/m-2. Patients with baseline systolic blood pressure <120 mmHg had a threefold increased risk of hypotension. The incidence of nausea and vomiting was 13.4 and 2.8%, respectively. The incidence of an Apgar score <7 at the first minute was 2.8%, and no neonates presented an Apgar score <7 at the fifth minute. A pH of <7.2 occurred in 6.3% of the neonates. All neonates had no sequelae and were discharged together with their mothers.ConclusionThe prophylactic infusion of phenylephrine 50 μg/min-1 is safe and demonstrates efficacy in reducing maternal hypotension providing adequate maternal hemodynamic stability during CS under spinal anesthesia.]]></description><subject>Acidosis</subject><subject>Anesthesiology</subject><subject>Apgar score</subject><subject>Blood pressure</subject><subject>Body mass index</subject><subject>Cardiac arrhythmia</subject><subject>Cesarean section</subject><subject>Data analysis</subject><subject>General anesthesia</subject><subject>Gestational age</subject><subject>GLP-1 receptor agonists</subject><subject>Heart rate</subject><subject>Hypertension</subject><subject>Hypotension</subject><subject>Medical personnel</subject><subject>Nausea</subject><subject>Obstetrics/Gynecology</subject><subject>Patients</subject><subject>Uterus</subject><subject>Vomiting</subject><issn>2168-8184</issn><issn>2168-8184</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><recordid>eNpdkstq3DAUhk1poSHNrg8g6KaLOtXFtqxVmU5zg5QGplkLWT4aK3gkV7IH3EfMU0WeCSXpSkL69Z3voJNlHwk-57wUX_UUYIrnBSVl9SY7oaSq85rUxdsX-_fZWYwPGGOCOcUcn2SPK3QXfBxAj3YPaGPdtod8DW6EgL4H9df2Vjm0Gad2RjduD3G0WzWmGBo7QBfGWK30jJRr0UYZGGfkzYIcurlXCarRXQdu7mHognWQGGaK1jtkfDggfiqntrBLFZeX1_PgR3CHxI8pLHXWEFWARWKRTOf3rk1ym8E61aOVS0odRKs-ZO-M6iOcPa-n2f3lxe_1dX776-pmvbrNNeV8zDle-tcEqBFUlFzgSlHFAKqyAkZYKwgRtamaxlSVZjWDxvCyaYsKKG8pZ6fZtyN3mJodtDqZB9XLIdidCrP0ysrXN852cuv3kuCC1YIvhM_PhOD_TMlf7mzU0PfKgZ-ipHVZsKIuRZ2in_6LPvgppMYPKVEIwplIqS_HlE5_GQOYfzYEy2U65HE65GE62BP1f7O6</recordid><startdate>20230719</startdate><enddate>20230719</enddate><creator>Benevides, Marcio L</creator><creator>Andrade, Breno Wilson B</creator><creator>Zambardino, Henry Manfried D</creator><creator>Benevides, Marco Antonio M</creator><general>Cureus Inc</general><general>Cureus</general><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20230719</creationdate><title>A Prospective Single-Center Brazilian Study Investigating the Efficacy and Safety of Prophylactic Phenylephrine Infusion for the Management of Hypotension During Cesarean Section Under Spinal Anesthesia</title><author>Benevides, Marcio L ; Andrade, Breno Wilson B ; Zambardino, Henry Manfried D ; Benevides, Marco Antonio M</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c277t-700001c1e2f92957906a2a3ee656e313d91198f6bbf66c383ebf75bd46e27d273</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Acidosis</topic><topic>Anesthesiology</topic><topic>Apgar score</topic><topic>Blood pressure</topic><topic>Body mass index</topic><topic>Cardiac arrhythmia</topic><topic>Cesarean section</topic><topic>Data analysis</topic><topic>General anesthesia</topic><topic>Gestational age</topic><topic>GLP-1 receptor agonists</topic><topic>Heart rate</topic><topic>Hypertension</topic><topic>Hypotension</topic><topic>Medical personnel</topic><topic>Nausea</topic><topic>Obstetrics/Gynecology</topic><topic>Patients</topic><topic>Uterus</topic><topic>Vomiting</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Benevides, Marcio L</creatorcontrib><creatorcontrib>Andrade, Breno Wilson B</creatorcontrib><creatorcontrib>Zambardino, Henry Manfried D</creatorcontrib><creatorcontrib>Benevides, Marco Antonio M</creatorcontrib><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Publicly Available Content Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Curēus (Palo Alto, CA)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Benevides, Marcio L</au><au>Andrade, Breno Wilson B</au><au>Zambardino, Henry Manfried D</au><au>Benevides, Marco Antonio M</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>A Prospective Single-Center Brazilian Study Investigating the Efficacy and Safety of Prophylactic Phenylephrine Infusion for the Management of Hypotension During Cesarean Section Under Spinal Anesthesia</atitle><jtitle>Curēus (Palo Alto, CA)</jtitle><date>2023-07-19</date><risdate>2023</risdate><volume>15</volume><issue>7</issue><spage>e42156</spage><epage>e42156</epage><pages>e42156-e42156</pages><issn>2168-8184</issn><eissn>2168-8184</eissn><abstract><![CDATA[BackgroundMaternal hypotension occurs in up to 80% of parturients during cesarean section (CS) under spinal anesthesia. Phenylephrine, a direct-acting α-1 agonist, has been widely recommended for the prevention of hypotension. We evaluated the efficacy and safety of phenylephrine infusion to prevent hypotension in obese and non-obese patients during cesarean section.MethodsOne hundred forty-one patients were included in this single-arm study. Patients received prophylactic phenylephrine infusion at a rate of 50 μg/min-1 immediately after spinal local anesthetic injection until delivery. Hypotension was defined as a systolic blood pressure <100 mmHg or <20% of baseline. The primary outcome was the incidence of hypotension.ResultsThe incidence of hypotension was 17%. The median and interquartile range (IQR) of the number of hypotensive episodes was 0 (0-0). It was observed that 79.1% of the patients had hypotension in the first six minutes. Reactive hypertension and bradycardia occurred in 20.5 and 12.7% of the patients, respectively. In addition, there was a higher incidence of bradycardia in pregnant women with a body index mass of < 30 kg/m-2. Patients with baseline systolic blood pressure <120 mmHg had a threefold increased risk of hypotension. The incidence of nausea and vomiting was 13.4 and 2.8%, respectively. The incidence of an Apgar score <7 at the first minute was 2.8%, and no neonates presented an Apgar score <7 at the fifth minute. A pH of <7.2 occurred in 6.3% of the neonates. All neonates had no sequelae and were discharged together with their mothers.ConclusionThe prophylactic infusion of phenylephrine 50 μg/min-1 is safe and demonstrates efficacy in reducing maternal hypotension providing adequate maternal hemodynamic stability during CS under spinal anesthesia.]]></abstract><cop>Palo Alto</cop><pub>Cureus Inc</pub><doi>10.7759/cureus.42156</doi><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 2168-8184 |
| ispartof | Curēus (Palo Alto, CA), 2023-07, Vol.15 (7), p.e42156-e42156 |
| issn | 2168-8184 2168-8184 |
| language | eng |
| recordid | cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_10438977 |
| source | PubMed Central Open Access; PubMed Central |
| subjects | Acidosis Anesthesiology Apgar score Blood pressure Body mass index Cardiac arrhythmia Cesarean section Data analysis General anesthesia Gestational age GLP-1 receptor agonists Heart rate Hypertension Hypotension Medical personnel Nausea Obstetrics/Gynecology Patients Uterus Vomiting |
| title | A Prospective Single-Center Brazilian Study Investigating the Efficacy and Safety of Prophylactic Phenylephrine Infusion for the Management of Hypotension During Cesarean Section Under Spinal Anesthesia |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-12T08%3A49%3A56IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_pubme&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=A%20Prospective%20Single-Center%20Brazilian%20Study%20Investigating%20the%20Efficacy%20and%20Safety%20of%20Prophylactic%20Phenylephrine%20Infusion%20for%20the%20Management%20of%20Hypotension%20During%20Cesarean%20Section%20Under%20Spinal%20Anesthesia&rft.jtitle=Cur%C4%93us%20(Palo%20Alto,%20CA)&rft.au=Benevides,%20Marcio%20L&rft.date=2023-07-19&rft.volume=15&rft.issue=7&rft.spage=e42156&rft.epage=e42156&rft.pages=e42156-e42156&rft.issn=2168-8184&rft.eissn=2168-8184&rft_id=info:doi/10.7759/cureus.42156&rft_dat=%3Cproquest_pubme%3E2854348598%3C/proquest_pubme%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2859491739&rft_id=info:pmid/&rfr_iscdi=true |