Vasopressors in obstetric anesthesia: A current perspective

Abstract

Vasopressors are routinely used to counteract hypotension after neuraxial anesthesia in Obstetrics. The understanding of the mechanism of hypotension and the choice of vasopressor has evolved over the years to a point where phenylephrine has become the preferred vasopressor. Due to the absence of definitive evidence showing absolute clinical benefit of one over the other, especially in emergency and high-risk Cesarean sections, our choice of phenylephrine over the other vasopressors like mephentermine, metaraminol, and ephedrine is guided by indirect evidence on fetal acid-base status. This review article evaluates the present day evidence on the various vasopressors used in obstetric anesthesia today.

Keywords: Cesarean section; Hypotension; Obstetrics; Spinal anesthesia; Vasopressor agents.

Figures

Figure 1

Suggested clinical protocol for intravenous use of vasopressor for Hypotension after Neuraxial Anaesthesia in Obstetrics.