Blood pressure management for caesarean delivery under spinal anaesthesia: a UK multi-centre audit (2023)
Authors' conclusion
Intraoperative hypotension is common, and there is lack of adherence to guidance, including variation in choice and administration method of prophylactic vasopressors.
Study context
- Population
- Adults undergoing caesarean delivery under spinal anaesthesia, West Midlands, UK
- Participants
- 526 adults
- Outcome
- Maintenance of intra-operative SBP at ≥90% baseline
Main finding
As reported in the abstract
Intra-operative SBP maintained ≥90% baseline
Primary outcome achieved
9.1%
Systolic blood pressure (SBP) within 80-90% of baseline
65.0%
SBP below 80% of baseline
25.9%
Observational data: associations, not effects.
Further findings
Vasopressor choice and administration
- Phenylephrine first-line vasopressor
- 91%
- Administered via rate-controlled device
- 73.8%
- Compliance with consensus recommendation (prophylactic phenylephrine via rate-controlled device at 25-50 μg/min)
- 37.6%
SBP decrease to <80% of baseline with rate-controlled pump for prophylactic vasopressors
- Rate-controlled pump use associated with reduced incidence of SBP decrease to <80% of baseline
- P < 0.01
- Secondary analysis
Safety
Clinician-reported intra-operative nausea and vomiting
- Nausea
- 24.9%
- Vomiting
- 8.4%
Original publication
Blood pressure management for caesarean delivery under spinal anaesthesia: a UK multi-centre audit (2023). Int J Obstet Anesth. Published 21 March 2025. doi:10.
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