{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T06:23:27Z","timestamp":1789712607047,"version":"4.0.1"},"reference-count":21,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2013,11,20]],"date-time":"2013-11-20T00:00:00Z","timestamp":1384905600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Anaesthesia"],"published-print":{"date-parts":[[2014,1]]},"abstract":"<jats:title>Summary<\/jats:title>\n                  <jats:p>\n                    Hypotension necessitating vasopressor administration occurs commonly during caesarean section under spinal anaesthesia. We developed a novel vasopressor delivery system that automatically administers phenylephrine or ephedrine based on continuous non\u2010invasive arterial pressure monitoring. A phenylephrine bolus of 50\u00a0\u03bcg was given at 30\u2010s intervals when systolic blood pressure fell &lt;\u00a090% of baseline; an ephedrine bolus of 4 mg was given instead if systolic pressure fell &lt;\u00a090% of baseline together with a heart rate &lt;\u00a060\u00a0beats.min\n                    <jats:sup>\u22121<\/jats:sup>\n                    . The control group used manual boluses of either phenylephrine 100\u00a0\u03bcg or ephedrine 8\u00a0mg, administered at 1\u2010min intervals based on the same thresholds for systolic pressure and heart rate. This randomised, controlled, double\u2010blinded trial involved 213 healthy women who underwent elective caesarean delivery under spinal anaesthesia using 11\u00a0mg hyperbaric bupivacaine with 15\u00a0\u03bcg fentanyl and 100\u00a0\u03bcg morphine. The automated vasopressor group had better systolic pressure control, with 37\/106 (34.9%) having any beat\u2010to\u2010beat systolic pressure reading &lt;\u00a080% of baseline compared with 63\/107 (58.9%) in the control group (p\u00a0&lt;\u00a00.001). There was no difference in the incidence of reactive hypertension, defined as systolic pressure &gt; 120% of baseline, with 8\/106 (7.5%) in the automated vasopressor group vs 14\/107 (13.1%) in the control group, or total dose of vasopressors. The automated vasopressor group had lower median absolute performance error of 8.5% vs control of 9.8% (p\u00a0=\u00a00.013), and reduced incidence of nausea (1\/106 (0.9%) vs 11\/107 (10.3%), p\u00a0=\u00a00.005). Neonatal umbilical cord pH, umbilical lactate and Apgar scores were similar. Hence, our system afforded better control of maternal blood pressure and reduced nausea with no increase in reactive hypertension when compared with manual boluses.\n                  <\/jats:p>","DOI":"10.1111\/anae.12460","type":"journal-article","created":{"date-parts":[[2013,11,20]],"date-time":"2013-11-20T08:45:53Z","timestamp":1384937153000},"page":"37-45","source":"Crossref","is-referenced-by-count":65,"title":["Closed\u2010loop double\u2010vasopressor automated system vs manual bolus vasopressor to treat hypotension during spinal anaesthesia for caesarean section: a randomised controlled trial"],"prefix":"10.1111","volume":"69","author":[{"given":"B. L.","family":"Sng","sequence":"first","affiliation":[{"name":"Department of Women's Anaesthesia KK Women's and Children's Hospital Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H. S.","family":"Tan","sequence":"additional","affiliation":[{"name":"Duke\u2010NUS Graduate Medical School Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A. T. H.","family":"Sia","sequence":"additional","affiliation":[{"name":"Department of Women's Anaesthesia KK Women's and Children's Hospital Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2013,11,20]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/ACO.0b013e328337ffc6"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0029-7844(98)00105-7"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000539-199602000-00012"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9378(91)90433-R"},{"key":"e_1_2_7_6_1","doi-asserted-by":"crossref","first-page":"41","DOI":"10.1016\/S0002-9378(16)34639-7","article-title":"Pressure\u2010flow relationship in the gravid uterine vascular bed","volume":"96","author":"Greiss FC","year":"1966","journal-title":"American Journal of Obstetrics and Gynecology"},{"key":"e_1_2_7_7_1","first-page":"CD002251","article-title":"Techniques for preventing hypotension during spinal anaesthesia for caesarean section","volume":"4","author":"Cyna AM","year":"2006","journal-title":"Cochrane Database of Systematic Reviews"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000539-200204000-00028"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000542-200212000-00034"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/anae.12000"},{"key":"e_1_2_7_11_1","unstructured":"2009 R Hanss C Ilies H Missalla M Steinfath B Bein Continuous non\u2010invasive blood pressure monitoring during spinal anesthesia for cesarean section A827"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/aer394"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/aeq143"},{"key":"e_1_2_7_14_1","first-page":"328","article-title":"Sample size estimation for clinicians","volume":"24","author":"Archibald CP","year":"1995","journal-title":"Annals of the Academy of Medicine Singapore"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2044.2007.05257.x"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF01143186"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000542-200510000-00012"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/aes339"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1213\/ANE.0b013e31826ac3db"},{"key":"e_1_2_7_20_1","doi-asserted-by":"publisher","DOI":"10.1213\/01.ANE.0000099782.78002.30"},{"key":"e_1_2_7_21_1","doi-asserted-by":"publisher","DOI":"10.1213\/ANE.0b013e3181e1db21"},{"key":"e_1_2_7_22_1","doi-asserted-by":"publisher","DOI":"10.1213\/ANE.0b013e3181f2eae1"}],"container-title":["Anaesthesia"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fanae.12460","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/associationofanaesthetists-publications.onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/anae.12460","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,28]],"date-time":"2025-10-28T22:57:09Z","timestamp":1761692229000},"score":1,"resource":{"primary":{"URL":"https:\/\/associationofanaesthetists-publications.onlinelibrary.wiley.com\/doi\/10.1111\/anae.12460"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2013,11,20]]},"references-count":21,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2014,1]]}},"alternative-id":["10.1111\/anae.12460"],"URL":"https:\/\/doi.org\/10.1111\/anae.12460","archive":["Portico"],"relation":{},"ISSN":["0003-2409","1365-2044"],"issn-type":[{"value":"0003-2409","type":"print"},{"value":"1365-2044","type":"electronic"}],"subject":[],"published":{"date-parts":[[2013,11,20]]}}}