Effect of pneumatic leg compression on phenylephrine dose for hypotension prophylaxis via variable rate infusion at cesarean delivery: an unblinded randomized controlled trial.
Int J Obstet Anesth
; : 104218, 2024 Jun 11.
Article
en En
| MEDLINE
| ID: mdl-38925990
ABSTRACT
BACKGROUND:
Phenylephrine infusion is recommended to prevent spinal hypotension during cesarean delivery (CD) but may be associated with dose-dependent side effects. We hypothesized that adding intermittent pneumatic compression (IPC) of the lower legs to a variable-rate phenylephrine infusion will reduce the dose of phenylephrine required during CD.METHODS:
Seventy-six healthy women undergoing elective CD under combined spinal-epidural anesthesia were randomly assigned to IPC or control groups (nâ¯=â¯38 per group). After spinal anesthesia, IPC of the lower legs was initiated in the IPC group, and all women received a phenylephrine infusion starting at 25⯵g·min-1 and increasing by 16.7⯵g·min-1 for systolic blood pressure (SAP)â¯<â¯90% baseline. If hypotension (SAPâ¯<â¯80% baseline) occurred, 100⯵g phenylephrine bolus was administered. The primary outcome was the dose of phenylephrine per minute.RESULTS:
The dose of phenylephrine per minute (34.4⯱â¯7.3⯵g·min-1 vs. 40.9⯱â¯9.5⯵g·min-1, Pâ¯=â¯0.001; mean difference -6.6⯵g·min-1, 95% CI -10.5 to -2.7⯵g·min-1) and the incidence of hypotension (24% vs. 55%, Pâ¯=â¯0.005) were lower in the IPC group than in the control group. There were no significant differences between the two groups in the total dose of phenylephrine (603.2⯱â¯217.1⯵g vs. 706.2⯱â¯247.5⯵g, Pâ¯=â¯0.058; mean difference -102.9⯵g, 95% CI -209.4 to 3.5⯵g), maternal side effects, or neonatal outcomes.CONCLUSIONS:
Intermittent pneumatic compression combined with a variable-rate phenylephrine infusion reduced the phenylephrine dose per minute and the incidence of hypotension during CD under spinal anesthesia.
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Idioma:
En
Revista:
Int J Obstet Anesth
Asunto de la revista:
ANESTESIOLOGIA
/
OBSTETRICIA
Año:
2024
Tipo del documento:
Article
País de afiliación:
China
Pais de publicación:
Países Bajos