Management of Hypotension Post Subarachnoid Block in C Section Patients: What‘s the Difference between Ephedrine Vs Phenylephrine?

Sirait, Robert Hotman (2025) Management of Hypotension Post Subarachnoid Block in C Section Patients: What‘s the Difference between Ephedrine Vs Phenylephrine? International Blood Research & Reviews, 16 (3). pp. 31-40. ISSN 2321–7219

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Abstract

Aims: The present review is aimed at revisiting the caesarean delivery under spinal anesthesia,comparing the application of two different vasopressors namely ephedrine and phenylephrine. Forunderstanding beneficiary along with unwanted hypotensive effect between the two drugs.Discussion: Elective cesarean sections are so commonly performed under spinal anesthesia.Unfortunately, this procedure often leads to hypotension, which may adversely jeopardize maternaland fetal outcomes. Immediate post spinal anesthesia hypotension is basically elucidated asreduction of normal blood pressure, estimated 80–90% below its baseline value. Various strategieshave been implemented to reduce the incidence of spinal anesthesia-induced hypotension,including the immediate administration of vasopressors such as phenylephrine and or ephedrine,aimed for preventing and treating hypotension. Clinically, both phenylephrine and ephedrine wereproven effective in protecting normal maternal hemodynamic balance by counteract the unwanted effect of hypotension both to the maternal and the newborn. Newborns benefited more from theapplication of phenylephrine in elective cesarean delivery, compared to those who receiveephedrine, but unfortunately not in unscheduled emergency cesarean delivery or in vulnerableparturient with pre-eclampsia. More in depth clinical study should be conducted to obtain moreconclusive results, especially regarding the most effective prevention and predictive method, itsactive surveillance during critical anesthesiology procedure throughout cesarean sectio andrecovery from hypotension chronologically.

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