The effects on Apgar scores and neonatal outcomes of switching from a combination of phenylephrine and ephedrine to phenylephrine alone as a prophylactic vasopressor during spinal anesthesia for cesarean section / 대한마취과학회지
Korean Journal of Anesthesiology
;
: 38-42, 2014.
Article
in English
| WPRIM
| ID: wpr-173268
ABSTRACT
BACKGROUND:
Ephedrine, unlike phenylephrine, has a dose-related propensity to depress fetal pH during spinal anesthesia during cesarean section. A low arterial umbilical cord pH has a strong association with neonatal mortality and morbidity. The purpose of this retrospective study was to investigate influences of vasopressor change on Apgar scores and adverse neonatal outcomes in cesarean section.METHODS:
In obstetric anesthesia, we changed the prophylactic vasopressor from a combination of phenylephrine and ephedrine to phenylephrine alone in 2000. We evaluated the impact of vasopressor change on Apgar scores (1 and 5 min), incidence of Apgar score < 7 (1 and 5 min), neonatal seizure, continuous positive airway pressure (CPAP), intermittent positive pressure ventilation (IPPV), intraventricular hemorrhage (IVH), periventricular leucomalacia (PVL), and hypoxic ischemic encephalopathy (HIE) in low-risk elective cesarean sections during a period when the combination of phenylephrine and ephedrine was used (2008-2009, two years) and the period of phenylephrine use alone (2011-2012, two years).RESULTS:
There were no differences in Apgar scores (1 and 5 min), the incidence of 5 min Apgar score < 7, neonatal seizure, CPAP, IPPV, IVH, PVL, and HIE between the two time periods. However, the incidence of 1 min Apgar < 7 was decreased during the period of phenylephrine use compared with the period of phenylephrine and ephedrine use (P = 0.002).CONCLUSIONS:
Conversion from a combination of phenylephrine and ephedrine to phenylephrine alone as a prophylactic anti-hypotensive drug during spinal anesthesia for cesarean section in low-risk pregnancy may be associated with a significant decrease in the incidence of 1 min Apgar < 7.
Full text:
Available
Index:
WPRIM (Western Pacific)
Main subject:
Apgar Score
/
Phenylephrine
/
Seizures
/
Umbilical Cord
/
Leukomalacia, Periventricular
/
Cesarean Section
/
Infant Mortality
/
Incidence
/
Retrospective Studies
/
Intermittent Positive-Pressure Ventilation
Type of study:
Incidence study
/
Observational study
/
Prognostic study
/
Risk factors
Limits:
Female
/
Humans
/
Infant
/
Infant, Newborn
/
Pregnancy
Language:
English
Journal:
Korean Journal of Anesthesiology
Year:
2014
Type:
Article
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