{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,8]],"date-time":"2026-05-08T05:01:02Z","timestamp":1778216462604,"version":"3.51.4"},"reference-count":35,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2012,2,7]],"date-time":"2012-02-07T00:00:00Z","timestamp":1328572800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Acta Anaesthesiol Scand"],"published-print":{"date-parts":[[2012,8]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Phenylephrine use has been recommended over ephedrine for the management of hypotension after spinal anesthesia for elective caesarean section. The evidence for this is rather limited because in previous trials, <jats:styled-content style=\"fixed-case\">pH<\/jats:styled-content> was significantly lower after ephedrine, but absolute values were still within normal range. We pooled the available data to define maternal and neonatal effects of the two vasopressors.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Literature was identified by a systematic search. Hypotension, hypertension, and bradycardia of the mothers, fetal acidosis defined as a <jats:styled-content style=\"fixed-case\">pH<\/jats:styled-content>\u2009&lt;\u20097.20, and the continuous variables base excess (<jats:styled-content style=\"fixed-case\">BE<\/jats:styled-content>) and arterial <jats:styled-content style=\"fixed-case\"><jats:roman>pCO<jats:sub>2<\/jats:sub><\/jats:roman><\/jats:styled-content> of the neonates were recorded. Meta\u2010analysis using the random effects model was performed, and the weighted mean difference (<jats:styled-content style=\"fixed-case\">WMD<\/jats:styled-content>) or risk ratio (<jats:styled-content style=\"fixed-case\">RR<\/jats:styled-content>), and 95% confidence interval (95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>) were calculated.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The criteria for eligibility were fulfilled by 20 trials including 1069 patients. The RR of true fetal acidosis was 5.29 (95%<jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 1.62\u201317.25, ) for ephedrine vs. phenylephrine (<jats:italic><jats:styled-content style=\"fixed-case\">P<\/jats:styled-content><\/jats:italic>\u2009=\u20090.006). <jats:styled-content style=\"fixed-case\">BE<\/jats:styled-content> values after ephedrine use were significantly lower than after phenylephrine (<jats:styled-content style=\"fixed-case\">WMD<\/jats:styled-content> \u22121.17; 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> \u22122.01 \u2013 \u22120.33). Umbilical artery <jats:styled-content style=\"fixed-case\"><jats:roman>pCO<jats:sub>2<\/jats:sub><\/jats:roman><\/jats:styled-content> did not differ. Mothers treated with ephedrine had a lower risk for bradycardia (<jats:styled-content style=\"fixed-case\">RR<\/jats:styled-content> 0.17; 95%<jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 0.07\u20130.43; <jats:italic>P<\/jats:italic>\u2009=\u20090.004). No differences between vasopressors were observed for hypotension and hypertension.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Our analysis could clearly demonstrate a decreased risk of fetal acidosis associated with phenylephrine use. In addition with our findings for <jats:styled-content style=\"fixed-case\">BE<\/jats:styled-content>, this suggests a favorable effect of phenylephrine on fetal outcome parameters. The mechanism of <jats:styled-content style=\"fixed-case\">pH<\/jats:styled-content> depression is not related to <jats:styled-content style=\"fixed-case\"><jats:roman>pCO<jats:sub>2<\/jats:sub><\/jats:roman><\/jats:styled-content>.<\/jats:p><\/jats:sec>","DOI":"10.1111\/j.1399-6576.2011.02646.x","type":"journal-article","created":{"date-parts":[[2012,2,7]],"date-time":"2012-02-07T14:02:54Z","timestamp":1328623374000},"page":"810-816","source":"Crossref","is-referenced-by-count":120,"title":["Vasopressors for the management of hypotension after spinal anesthesia for elective caesarean section. 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