International journal of obstetric anesthesia
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Int J Obstet Anesth · Nov 2017
Randomized Controlled Trial Multicenter StudyNeonatal effects after vasopressor during spinal anesthesia for cesarean section: a multicenter, randomized controlled trial.
Placental transfer of ephedrine causes fetal effects when compared with phenylephrine. This study compared their drug effects on neonatal parameters after cesarean delivery under spinal anesthesia. ⋯ Ephedrine, compared to phenylephrine as a vasopressor during cesarean delivery, was associated with higher neonatal heart rate in the early post-birth period, but without a significant difference in clinical outcomes in uncomplicated pregnancies.
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Int J Obstet Anesth · Nov 2017
Review Meta AnalysisIntrathecal clonidine as an adjuvant for neuraxial anaesthesia during caesarean delivery: a systematic review and meta-analysis of randomised trials.
Clonidine is used as adjuvant to local anaesthetics for spinal anaesthesia. Its potential harm and benefits have not been systematically reviewed in obstetrics, and medical regulatory authorities do not recommend its intrathecal administration. The aim of this study was to assess the safety and efficacy of intrathecal clonidine for caesarean delivery. ⋯ Clonidine is an effective and safe adjuvant to local anaesthetics for spinal anaesthesia for caesarean delivery. This opens the debate as to whether intrathecal clonidine as an "off label" prescription should be reconsidered by medical regulatory authorities.