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Alpha-1 agonists may be preferable to ephedrine. (Vasopressors For Obstetric Hypotension).
HILTON HEAD, S.C. -- The [alpha]-1 agonists, long thought of as drugs of last resort for preventing hypotension associated with neuraxial analgesia in obstetric patients, may not be that bad after all, Dr. Michelle Chochinov reported.
The [alpha]-1 agonists phenylephrine, angiotensin, and metaraminol were relegated to second-tier status for preventing hypotension among obstetric patients after animal studies showed the agents had deleterious effects on uterine blood flow In their place, ephedrine became the vasopressor of choice for treating and preventing hypotension in obstetric settings. The [alpha]-1 agonists were reserved for situations in which ephedrine was contraindicated because of heart conditions such as tachycardia or coronary artery disease, she said at the annual meeting of the Society for Obstetric Anesthesia and Perinatology.
But in an analysis of data from several studies involving humans, [alpha]-1 agonists do not appear to have an adverse effect on uterine blood flow and may even be preferable to ephedrine.
Dr. Chochinov and colleagues at Sunnybrook and Women's College Health Sciences Centre, Toronto, culled the medical literature for studies published between 1966 and 2001 that compared ephedrine with an [alpha]-1 agonist for the treatment or prevention of hypotension due to neuraxial blockade during elective C-sections among women carrying full-term pregnancies.
They found 13 randomized controlled ...
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Source: HighBeam Research, Alpha-1 agonists may be preferable to ephedrine. (Vasopressors For...