Comparison of Phenylephrine Bolus and Infusion Regimens on Maternal and Fetal Outcomes During Cesarean Delivery: A Systematic Review and Meta-Analysis
Pooled result · Predelivery hypotensionResult — go to the resultRelative risk 2.34 95% CI 1.72–3.18Authors' conclusion
A prophylactic phenylephrine infusion significantly reduces the incidence of predelivery hypotension in parturients undergoing cesarean delivery under neuraxial anesthesia in comparison to the therapeutic or prophylactic phenylephrine bolus group.
Study context
- Population
- Parturients undergoing cesarean delivery under spinal or CSE anesthesia
- Participants
- 2,153 participants · 15 studies
- Comparison
- Phenylephrine bolus vs prophylactic infusion
- Outcome
- Incidence of maternal hypotension
Methodological detailsrandom effects model, Three studies had a high risk of bias
- Random effects model
- Three studies had a high risk of bias
Pooled result
Predelivery hypotension
Relative risk
2.34
95% CI 1.72–3.18
Bolus vs Infusion
RR 2.34 (95% CI 1.72–3.18)
As reported in the abstract
Further pooled results
Nausea and fetal outcomes (umbilical artery pH, paO2, umbilical venous pH, fetal acidosis, Apgar scores at 1 and 5 min)
- No statistically significant difference between groups
Safety
| Outcome | RR (95% CI) | |
|---|---|---|
| Reactive hypertension | 0.48 (0.29–0.79) | |
| Bradycardia | 0.57 (0.41–0.79) | |
| Vomiting | 2.15 (1.53–3.03) | |
| 0.20.5125Relative risk (log scale) |
Original publication
Comparison of Phenylephrine Bolus and Infusion Regimens on Maternal and Fetal Outcomes During Cesarean Delivery: A Systematic Review and Meta-Analysis. Anesth Analg. Published 15 November 2024. doi:10.
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