Efficacy and safety of different vasopressor infusions on feto‐maternal outcomes in normotensive patients undergoing caesarean delivery: a systematic review and network meta‐analysis of randomised controlled trials
Authors' conclusion
Current evidence suggests that continuous infusions of α-agonists with mild β-activity (e.g. noradrenaline, metaraminol) are preferable to mixed adrenergic agonists such as ephedrine for preventing maternal hypotension.
Study context
- Population
- Normotensive adults undergoing caesarean delivery under spinal or combined spinal and epidural anaesthesia
- Participants
- 5,487 adults · 55 trials
- Comparison
- Prophylactic vasopressor infusions vs each other and vs control
- Outcome
- Incidence of maternal hypotension and umbilical artery base excess
Pooled result
As reported in the abstract
Maternal hypotension
- Metaraminol, noradrenaline, phenylephrine and adrenaline 'definitely superior' to control for prevention of hypotension
- Mephentermine and metaraminol provided superior preservation of umbilical arterial and venous acid-base balance
Original publication
Efficacy and safety of different vasopressor infusions on feto‐maternal outcomes in normotensive patients undergoing caesarean delivery: a systematic review and network meta‐analysis of randomised controlled trials. Anaesthesia. Published 19 March 2026. doi:10.
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