{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,10]],"date-time":"2026-11-10T17:10:57Z","timestamp":1794330657982,"version":"4.9.0"},"reference-count":42,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2023,5,12]],"date-time":"2023-05-12T00:00:00Z","timestamp":1683849600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100004775","name":"Natural Science Foundation of Gansu Province","doi-asserted-by":"publisher","award":["21JR1RA092"],"award-info":[{"award-number":["21JR1RA092"]}],"id":[{"id":"10.13039\/501100004775","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Obstet and Gynaecol"],"published-print":{"date-parts":[[2023,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p>The aim of this study is to perform a Bayesian network meta\u2010analysis to evaluate the safety and efficacy of prophylactic bolus of different doses of ephedrine, phenylephrine, and norepinephrine for the prevention of spinal hypotension during cesarean section.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The Web of Science, PubMed, EMBASE, Cochrane Library were searched until to May 20, 2022. The indicators included incidence of hypotension, reactive hypertension, bradycardia, nausea and vomiting, umbilical artery pH, and Apgar scores.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>About 3125 related records were obtained and 17 RCTs met our eligibility criteria. Based on the results, prophylactic bolus injection of 21\u201330\u2009mg ephedrine (82%) was the best efficacious option for preventing hypotension, followed by 13\u201316\u2009\u03bcg norepinephrine and 81\u2013120\u2009mg phenylephrine; 121\u2013150\u2009\u03bcg phenylephrine had the highest probability (62%) caused reactive hypertension, followed by 11\u201330\u2009mg ephedrine; phenylephrine was most likely to cause bradycardia in a dose\u2010dependent manner; 81\u2013120\u2009\u03bcg phenylephrine had the highest probability (37%) which associated with IONV; 6\u201312\u2009\u03bcg norepinephrine (31%) had the lowest influence on IONV and had highest probability (34%) associated with improving umbilical arterial pH; 13\u201316\u2009\u03bcg norepinephrine had highest probability (67% at 1\u2009min, 49% at 5\u2009min) which associated with improving Apgar scores.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Based on this study, 5\u201310\u2009mg ephedrine and 13\u201316\u2009\u03bcg norepinephrine prophylactic bolus injection may be the optimum dosage of three drugs prevent spinal\u2010induced hypotension, which has the least impact on maternal and neonatal outcomes.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jog.15671","type":"journal-article","created":{"date-parts":[[2023,5,12]],"date-time":"2023-05-12T08:30:28Z","timestamp":1683880228000},"page":"1651-1662","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Prevention of spinal hypotension during cesarean section: A systematic review and Bayesian network meta\u2010analysis based on ephedrine, phenylephrine, and norepinephrine"],"prefix":"10.1111","volume":"49","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0987-8656","authenticated-orcid":false,"given":"Xing","family":"Xue","sequence":"first","affiliation":[{"name":"Department of Anaesthesiology The First Hospital of Lanzhou University  Lanzhou 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