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Medicas UIS

Print version ISSN 0121-0319


PUENTES-VEGA, Nelly Johanna; MELENDEZ-FLOREZ, Héctor Julio  and  ALVARADO-ARTEAGA, Jorge de Lujan. Effectiveness of phenylefrine in prevention of hypotension during spinal anesthesia for cesarean delivery. Medicas UIS [online]. 2018, vol.31, n.2, pp.33-39. ISSN 0121-0319.


Hypotension is the most common adverse event when subarachnoid anesthesia is administered for cesarean section; multiple strategies for its prevention and management have been proposed, including the use of prophylactic vasopressors with inconclusive results.


To evaluate the preventive efficacy of the use of phenylephrine in hypotension induced by subarachnoid anesthesia in pregnant women taken to caesarean section.


A double-blind, controlled clinical trial in pregnant women, older than 18 years old, ASA 1 and 2, who received a subarachnoid anesthesia for cesarean section, were randomized to receive placebo or prophylactic infusion of phenylephrine 40 mcg / min, for 5 minutes.


140 patients were included in data analysis. Incidence of hypotension was higher in the control group than in the intervention group (AR 45.71% vs 32.85%). There were no significant differences between the two groups (p = 0.119). RR of hypotension in the intervention group were lower, independent of the criterion of hypotension [systolic blood pressure, RR 0.72 (95% CI 0.47-1.09), mean arterial pressure, RR 0.93 (95% CI 0.64-1.37), SBP or MAP 0.86 (RR 0.86) (IC95% 0.62-1.21)], but without significant differences p> 0.05. The use of vasopressors in patients who presented this event occurred in 75.4% (n = 52), with higher RR in the control group and significant differences when evaluating the two groups. (RR 1.4 p = 0.032).


Prophylactic phenylephrine did not prove effective in reducing the incidence of hypotension, however, it is associated with a significant decrease in vasopressor requirements, as well as in the incidence of nausea and vomiting. MÉD.UIS. 2018;31(2):33-9.

Keywords : Cesarean Section; Spinal anesthesia; Hypotension; Phenylephrine.

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