The use of epinephrine infusion for the prevention of spinal hypotension during Caesarean delivery: A randomized controlled dose-finding trial
Authors' conclusion
An initial dose of 0.03 mcg/kg/min produced the lowest incidence of hypotension compared to 0.02 mcg/kg/min and 0.01 mcg/kg/min doses.
Study context
- Population
- Full-term pregnant women undergoing elective Caesarean delivery under spinal anesthesiafinal analysis
- Participants
- 271 women
- Comparison
- Prophylactic epinephrine infusion at 0.03 vs 0.02 vs 0.01 mcg/kg/min
- 0.01 mcgn = 90reference
- 0.02 mcgn = 91
- 0.03 mcgn = 90
- Primary endpoint
- Incidence of spinal hypotension (SBP <80% of baseline)
Methodological detailsdose-finding, Spinal hypotension managed with a 9-mg ephedrine bolus
- Dose-finding
- Spinal hypotension managed with a 9-mg ephedrine bolus
Primary result
As reported in the abstract
Spinal hypotension
P < 0.001
Secondary outcomes
Ephedrine requirement
Severe hypotension
Severe hypotension
- Lower in the 0.03 mcg and 0.02 mcg groups than in the 0.01 mcg group
Safety
Excessive tachycardia, hypertension, neonatal outcomes
- Comparable among the groups
Original publication
The use of epinephrine infusion for the prevention of spinal hypotension during Caesarean delivery: A randomized controlled dose-finding trial. Anaesth Crit Care Pain Med. Published 28 February 2023. doi:10.
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