{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T20:37:08Z","timestamp":1786739828948,"version":"build-2736575974"},"reference-count":18,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"8","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2021,8]]},"abstract":"<jats:sec>\n                    <jats:title>Background and Aims:<\/jats:title>\n                    <jats:p>Phenylephrine is the vasopressor of choice in spinal anaesthesia\u2013induced maternal hypotension. However, it results in reflex bradycardia and decrease in cardiac output (CO), an effect that is perhaps less evident with the use of norepinephrine. We sought to evaluate the effect of phenylephrine and norepinephrine infusion on maternal systolic blood pressure (SBP), heart rate (HR), intraoperative nausea vomiting (IONV) and fatal Apgar scores.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>A randomised double-blind study was conducted on 200 American Society of Anesthesiologists (ASA) II\u2013III parturients undergoing caesarean section under subarachnoid block (SAB) who were randomised to two groups A and B to receive variable rate, manually controlled infusions of phenylephrine and norepinephrine targeting maintenance of SBP to 100% of the baseline value. Maternal haemodynamics especially episodes of hypotension, IONV and vasopressor consumption were observed and recorded.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      A statistically significant trend of lower SBP was observed during the first 6 min following intrathecal injection in group A (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      value \u2013 0.000). Though a greater number of parturients experienced \u22651 episode of hypotension in Group A vs Group B (13% vs 9%), the difference was, however, statistically insignificant. The incidence of bradycardia was higher in group A than in group B (16% vs 1%) and was found to be statistically significant (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.05). The episodes of hypertension, IONV, maternal vasopressor consumption and neonatal Apgar score were comparable among both the groups.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>A dilute solution of norepinephrine infusion is comparably efficacious to the current gold standard vasopressor phenylephrine in maintaining blood pressure following spinal anaesthesia for caesarean delivery, with a significantly lower incidence of bradycardia.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/ija.ija_185_21","type":"journal-article","created":{"date-parts":[[2021,9,14]],"date-time":"2021-09-14T07:43:16Z","timestamp":1631605396000},"page":"600-605","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":9,"title":["Comparison of norepinephrine and phenylephrine infusions for maintenance of haemodynamics following subarachnoid block in lower segment caeserean section"],"prefix":"10.4103","volume":"65","author":[{"given":"Kanika","family":"Goel","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Neeru","family":"Luthra","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Namrata","family":"Goyal","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anju","family":"Grewal","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ashima","family":"Taneja","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"R1-6-20240902","doi-asserted-by":"crossref","first-page":"736","DOI":"10.1097\/ALN.0000000000000601","article-title":"Randomized double-blinded comparison of norepinephrine and phenylephrine for maintenance of blood pressure during spinal anesthesia for cesarean delivery","volume":"122","author":"Ngan","year":"2015","journal-title":"Anesthesiology"},{"key":"R2-6-20240902","doi-asserted-by":"crossref","first-page":"995","DOI":"10.4103\/ija.IJA_481_19","article-title":"Comparison of norepinephrine and phenylephrine boluses for the treatment of hypotension during spinal anaesthesia for caesarean section \u2013A randomised controlled trial","volume":"63","author":"Puthenveettil","year":"2019","journal-title":"Indian J Anaesth"},{"key":"R3-6-20240902","doi-asserted-by":"crossref","first-page":"36","DOI":"10.4103\/ija.IJA_416_17","article-title":"Maternal and anaesthesia-related risk factors and incidence of spinal anaesthesia-induced hypotension in elective caesarean section:A multinomial logistic regression","volume":"62","author":"Fakherpour","year":"2018","journal-title":"Indian J Anaesth"},{"key":"R4-6-20240902","doi-asserted-by":"crossref","first-page":"235","DOI":"10.4103\/ija.IJA_91_20","article-title":"Intravenous norepinephrine and mephentermine for maintenance of blood pressure during spinal anaesthesia for caesarean section:An interventional double-blinded randomised trial","volume":"64","author":"Shah","year":"2020","journal-title":"Indian J Anaesth"},{"key":"R5-6-20240902","doi-asserted-by":"crossref","first-page":"59","DOI":"10.1093\/bja\/aes339","article-title":"Randomized comparison of closed-loop feedback computer-controlled with manual-controlled infusion of phenylephrine for maintaining arterial pressure during spinal anaesthesia for caesarean delivery","volume":"110","author":"Ngan","year":"2013","journal-title":"Br J Anaesth"},{"key":"R6-6-20240902","doi-asserted-by":"crossref","first-page":"728","DOI":"10.1097\/ALN.0000000000000602","article-title":"Norepinephrine for spinal hypotension during cesarean delivery:Another paradigm shift?","volume":"122","author":"Carvalho","year":"2015","journal-title":"Anesthesiology"},{"key":"R7-6-20240902","doi-asserted-by":"crossref","first-page":"1251","DOI":"10.1111\/j.1365-2044.2007.05257.x","article-title":"Closed-loop feedback computer-controlled infusion of phenylephrine for maintaining blood pressure during spinal anaesthesia for caesarean section:A preliminary descriptive study","volume":"62","author":"Ngan","year":"2007","journal-title":"Anaesthesia"},{"key":"R8-6-20240902","doi-asserted-by":"crossref","first-page":"300","DOI":"10.1097\/ACO.0b013e3283530d62","article-title":"Caesarean delivery vasopressor management","volume":"25","author":"Cooper","year":"2012","journal-title":"Curr Opin Anaesthesiol"},{"key":"R9-6-20240902","doi-asserted-by":"crossref","first-page":"909","DOI":"10.1111\/j.1399-6576.2010.02239.x","article-title":"Definitions of hypotension after spinal anaesthesia for caesarean section:Literature search and application to parturients","volume":"54","author":"Kl\u00f6hr","year":"2010","journal-title":"Acta Anaesthesiol Scand"},{"key":"R10-6-20240902","doi-asserted-by":"crossref","first-page":"1989","DOI":"10.1213\/ANE.0000000000002243","article-title":"Prophylactic norepinephrine infusion for preventing hypotension during spinal anesthesia for cesarean delivery","volume":"126","author":"Ngan","year":"2018","journal-title":"Anesth Analg"},{"key":"R11-6-20240902","doi-asserted-by":"crossref","first-page":"469","DOI":"10.1093\/bja\/aeh088","article-title":"Comparison of phenylephrine infusion regimens for maintaining maternal blood pressure during spinal anaesthesia for Caesarean section","volume":"92","author":"Ngan","year":"2004","journal-title":"Br J Anaesth"},{"key":"R12-6-20240902","doi-asserted-by":"crossref","first-page":"153","DOI":"10.1097\/CRD.0b013e31824e2294","article-title":"Vasopressor use in adult patients","volume":"20","author":"Ferguson-Myrthil","year":"2012","journal-title":"Cardiol Rev"},{"key":"R13-6-20240902","first-page":"12315","article-title":"Comparison of prophylactic bolus norepinephrine and phenylephrine on hypotension during spinal anesthesia for cesarean section","volume":"10","author":"Dong","year":"2017","journal-title":"Int J Clin Exp Med"},{"key":"R14-6-20240902","doi-asserted-by":"crossref","first-page":"463","DOI":"10.1111\/j.1748-1716.1989.tb08688.x","article-title":"Comparative effects of the alpha-adrenoceptor agonists noradrenaline, phenylephrine and clonidine in the human saphenous vein in vivo and in vitro","volume":"136","author":"Sj\u00f6berg","year":"1989","journal-title":"Acta Physiol Scand"},{"key":"R15-6-20240902","doi-asserted-by":"crossref","first-page":"834","DOI":"10.1097\/00000542-199305000-00005","article-title":"Effect of phenylephrine bolus administration on global left ventricular function in patients with coronary artery disease and patients with valvular aortic stenosis","volume":"78","author":"Lindner","year":"1993","journal-title":"Anesthesiology"},{"key":"R16-6-20240902","doi-asserted-by":"crossref","first-page":"227","DOI":"10.1213\/00000539-199308000-00004","article-title":"The effect of phenylephrine bolus administration on left ventricular function during isoflurane-induced hypotension","volume":"77","author":"Goertz","year":"1993","journal-title":"Anesth Analg"},{"key":"R17-6-20240902","doi-asserted-by":"crossref","first-page":"934","DOI":"10.1097\/ALN.0000000000001880","article-title":"A random-allocation graded dose-response study of norepinephrine and phenylephrine for treating hypotension during spinal anesthesia for cesarean delivery","volume":"127","author":"Ngan","year":"2017","journal-title":"Anesthesiology"},{"key":"R18-6-20240902","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.ijoa.2017.01.002","article-title":"More perfect?","volume":"29","author":"Smiley","year":"2017","journal-title":"Int J Obstet Anesth"}],"container-title":["Indian Journal of Anaesthesia"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/ija.IJA_185_21","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T19:34:21Z","timestamp":1786736061000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/ija.IJA_185_21"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,8]]},"references-count":18,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2021]]}},"URL":"https:\/\/doi.org\/10.4103\/ija.ija_185_21","relation":{},"ISSN":["0019-5049"],"issn-type":[{"value":"0019-5049","type":"print"}],"subject":[],"published":{"date-parts":[[2021,8]]}}}