Comparison of a Modified Regimen of Prophylactic Phenylephrine Boluses Versus Variable Rate Infusion During Elective Cesarean Delivery Under Spinal Anesthesia: A Noninferiority Randomized Double-Blind Study.

In 30 seconds

This randomized controlled trial compared a modified regimen of prophylactic phenylephrine boluses to a variable rate infusion during elective cesarean deliveries under spinal anesthesia in healthy pregnant women. The bolus regimen required significantly fewer physician interventions (3 vs 6, P < .001) while maintaining similar maternal and neonatal outcomes, demonstrating non-inferiority to the infusion method.

Key findings

• The bolus group required a median of 3 physician interventions compared to 6 in the infusion group (P < .001).
• Phenylephrine requirements were significantly lower in the bolus group (300 µg) than in the infusion group (630 µg; P < .001).
• No significant differences were found in the incidence of hypotension, hypertension, bradycardia, or neonatal outcomes between the groups.

Why it matters

This study highlights an effective alternative to variable rate infusions for maintaining blood pressure during cesarean deliveries, potentially reducing the workload for clinicians while ensuring patient safety and outcomes.