{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,6]],"date-time":"2025-12-06T17:14:43Z","timestamp":1765041283411,"version":"3.40.5"},"reference-count":14,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2022,5,22]],"date-time":"2022-05-22T00:00:00Z","timestamp":1653177600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Obstet and Gynaecol"],"published-print":{"date-parts":[[2022,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p>To compare incidences of abnormal heart rate (HR) between the phenylephrine\/ephedrine protocol (P\/E protocol) against the ephedrine\u2010only (C) protocol, conventionally used for treating predelivery hypotension following spinal anesthesia for cesarean section.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Two hundred and sixty\u2010eight parturients with pre\u2010delivery hypotension after spinal anesthesia were equally randomized to (1) Group P\/E (<jats:italic>n<\/jats:italic>\u00a0=\u00a0134), phenylephrine 100 mcg in 10\u00a0mL intravenously if HR\u2009\u2265\u200960\u2009beats\/min (bpm), or ephedrine 6\u00a0mg intravenously if HR\u2009&lt;\u200960\u2009bpm, and 2) Group C (<jats:italic>n<\/jats:italic>\u00a0=\u00a0134). The primary outcome was the incidence of the parturients with abnormal HR after vasopressor administration. The secondary outcome was the mean differences of HR and hypotensive periods during the pre\u2010delivery period.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>There was no significant difference of between\u2010group incidences of bradycardia (12.0% in Group P\/E vs 6.7% in Group C, <jats:italic>p\u2009=<\/jats:italic>\u00a00.136) and tachycardia (26.9% vs 35.8%, <jats:italic>p<\/jats:italic>\u00a0=\u00a00.114). Mean HR was 81.9\u00a0bpm (95% confidence interval [CI] 79.9, 84.3) in Group P\/E, and 88.8\u00a0bpm (86.8, 90.6) in Group C (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). The duration of hypotension in relation to the time interval from spinal anesthesia to delivery was 20.9% (95% CI 18.4\u201323.2) in Group P\/E, and 26.5% (23.9\u201329.3) in Group C (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.01). The calculated area under the curve (AUC) of abnormal HR in relation to time was significantly reduced only in Group P\/E (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.010).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The incidences of out\u2010of\u2010range HR were comparable, but the P\/E protocol resulted in a lower mean HR and better control of systolic blood pressure than the ephedrine\u2010only protocol.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jog.15289","type":"journal-article","created":{"date-parts":[[2022,5,23]],"date-time":"2022-05-23T00:29:16Z","timestamp":1653265756000},"page":"1750-1759","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["A randomized comparison of hemodynamic changes in response to a heart rate\u2010dependent phenylephrine\/ephedrine protocol versus ephedrine\u2010only for spinal hypotension during elective cesarean section"],"prefix":"10.1111","volume":"48","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0042-4300","authenticated-orcid":false,"given":"Ketchada","family":"Uerpairojkit","sequence":"first","affiliation":[{"name":"Department of Anesthesiology, Faculty of Medicine Chulalongkorn University  Bangkok Thailand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nutnicha","family":"Thongthaweeporn","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology Samutprakarn Hospital  Samutprakarn Thailand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ratikorn","family":"Anusorntanawat","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology Chaophrayayommarat Hospital  Suphan Buri Thailand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tanyong","family":"Pipanmekaporn","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology Chiang Mai University  Chiang Mai Thailand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thanoo","family":"Hinthong","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology Chiang Mai University  Chiang Mai Thailand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nutchanart","family":"Bunchungmongkol","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology Chiang Mai University  Chiang Mai Thailand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nawaporn","family":"Simarangsan","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Faculty of Medicine Chulalongkorn University  Bangkok Thailand"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2022,5,22]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/ALN.0b013e3181b160a3"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000542-200212000-00034"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2044.2003.02888.x"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijoa.2016.08.005"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/ALN.0000000000001880"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/ALN.0b013e3181b437e0"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinane.2016.11.001"},{"key":"e_1_2_9_9_1","first-page":"188","article-title":"Safety of phenylephrine in Antihypotensive treatment during spinal anesthesia for cesarean section","volume":"99","author":"Anusorntanawat 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