Current recognition of vasopressors in obstetric anesthesia

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Fudan University Journal of Medical Sciences ›› 2008, Vol. 35 ›› Issue (3) : 464-0.

综述

Current recognition of vasopressors in obstetric anesthesia

HUANG Shao-qiang

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Abstract

Abstract Historically, ephedrine has been recommended as the best vasopressor in obstetrics because animal studies showed it caused less reduction in uterine blood flow compared with -agonists. However, recent evidence from clinical trials suggests that concerns about uteroplacental vasoconstriction caused by phenylephrine and other -agonists are exaggerated. Ephedrine may cause maternal tachycardia and depresses fetal pH and base excess because of its stimulating metabolism. Whereas advantages of phenylephrine include high efficacy for treating and preventing hypotension, ease of titration and no report for its causing fetal acidosis. Although further work is still required in this area, when currently available evidence is taken into account, phenylephrine is the vasopressor that most closely meets the criteria for the best vasopressor to use in obstetric patients.