Calculation of effective dose of phenylephrine bolus for treatment of post-spinal hypotension in pre-eclamptic patients undergoing caesarean section – a non-randomised controlled trial
Authors' conclusion
Patients with pre-eclampsia may need a 33% to 40% reduction in the first phenylephrine bolus dose, compared with patients with normotension, for the treatment of the first episode of post-spinal hypotension.
Study context
- Population
- Patients with pre-eclampsia or normotension developing post-spinal hypotension during caesarean section under spinal anaesthesia, without prophylactic vasopressors
- Participants
- 50 patients
- Comparison
- Pre-eclampsia vs Normotensive
- Primary endpoint
- Effective dose (ED95, ED50) of phenylephrine bolus correcting the first episode of hypotension (SBP fall ≥20% from baseline or <100 mmHg) within one minute
Methodological detailsup-down sequential allocation (variation of Narayana's rule)
- Up-down sequential allocation (variation of Narayana's rule)
Primary result
As reported in the abstract
ED95 and ED50 of phenylephrine bolus
| Group | Value | Effective dose (ED50) |
|---|---|---|
| Pre-eclampsia | Effective dose (ED95) 41.7 (95% CI 33.8–49.6) µg | 29.1 µg (95% CI 26.0 to 32.2 µg) |
| Normotensive | ED95 64.9 (95% CI 54.1–75.7) µg | 47.3 µg (95% CI 39.7 to 54.9 µg) |
Value
Pre-eclampsiaED95 41.7 (95% CI 33.8–49.6) µg
NormotensiveED95 64.9 (95% CI 54.1–75.7) µg
Effective dose (ED50)
Pre-eclampsia29.1 µg (95% CI 26.0 to 32.2 µg)
Normotensive47.3 µg (95% CI 39.7 to 54.9 µg)
Original publication
Calculation of effective dose of phenylephrine bolus for treatment of post-spinal hypotension in pre-eclamptic patients undergoing caesarean section – a non-randomised controlled trial. Int J Obstet Anesth. Published 15 September 2023. doi:10.
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