Published online Jan 16, 2015. doi: 10.12998/wjcc.v3.i1.58
Peer-review started: July 27, 2014
First decision: August 14, 2014
Revised: August 25, 2014
Accepted: October 23, 2014
Article in press: December 23, 2014
Published online: January 16, 2015
Vasopressors are routinely used to counteract hypotension after neuraxial anesthesia in Obstetrics. The understanding of the mechanism of hypotension and the choice of vasopressor has evolved over the years to a point where phenylephrine has become the preferred vasopressor. Due to the absence of definitive evidence showing absolute clinical benefit of one over the other, especially in emergency and high-risk Cesarean sections, our choice of phenylephrine over the other vasopressors like mephentermine, metaraminol, and ephedrine is guided by indirect evidence on fetal acid-base status. This review article evaluates the present day evidence on the various vasopressors used in obstetric anesthesia today.
Core tip: Phenylephrine has emerged as the vasopressor of choice in Obstetrics. However, the present recom-mendations are essentially based on studies conducted in elective Cesarean sections. Further studies are needed in emergency and high risk Cesarean sections in order to clarify whether there is a benefit of phenyl-ephrine over other vasopressors.