Nag DS, Samaddar DP, Chatterjee A, Kumar H, Dembla A. Vasopressors in obstetric anesthesia: A current perspective. World J Clin Cases 2015; 3(1): 58-64 [PMID: 25610851 DOI: 10.12998/wjcc.v3.i1.58]
Corresponding Author of This Article
Dr. Deb Sanjay Nag, Department of Anaesthesiology and Critical Care, Tata Main Hospital, Jamshedpur 831011, India. debsanjay@gmail.com
Research Domain of This Article
Anesthesiology
Article-Type of This Article
Minireviews
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Deb Sanjay Nag, Devi Prasad Samaddar, Abhishek Chatterjee, Himanshu Kumar, Ankur Dembla, Department of Anaesthesiology and Critical Care, Tata Main Hospital, Jamshedpur 831011, India
Author contributions: Nag DS and Samaddar DP conceived the concept and the structure of the review; Nag DS, Samaddar DP, Chatterjee A, Kumar H and Dembla A searched the literature and wrote the review; Nag DS and Samaddar DP edited its final manuscript.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Dr. Deb Sanjay Nag, Department of Anaesthesiology and Critical Care, Tata Main Hospital, Jamshedpur 831011, India. debsanjay@gmail.com
Telephone: +91-943-1166582 Fax: +91-657-2424031
Received: July 26, 2014 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
Abstract
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.
