NA vs phenylephrine for hypotension following spinal for c section
Research type
Research Study
Full title
Comparison of noradrenaline and phenylephrine for the first-line management of hypotension following spinal anaesthesia for caesarean section, a retrospective observational study
IRAS ID
350523
Contact name
Victoria Randall
Contact email
Sponsor organisation
R&I - Homerton Healthcare NHS Foundation Trust
Duration of Study in the UK
0 years, 7 months, 1 days
Research summary
In England, up to 41% of deliveries in the NHS are by caesarean section. The current recommendation is that neuraxial anaesthesia (spinal or combined spinal-epidural) is offered for caesarean delivery. This allows the mother to be awake for the birth and carries better outcomes for both the mother and baby. It is therefore the anaesthetic technique used for 92% of caesarean deliveries. Spinal anaesthesia can result in low blood pressure (hypotension). Spinal related hypotension can cause problems for the mother (nausea, vomiting and dizziness) and the fetus (acidosis and reduced APGAR scores). It is therefore imperative that it is prevented and treated if it occurs.
Phenylephrine is a common drug of choice for management of spinal hypotension, however there is growing evidence for the use of noradrenaline. In our department we have recently switched to noradrenaline as the first-line agent and will be studying to compare maternal and fetal outcomes of both agents - this will add to the growing evidence around the use of noradrenaline.
This will be a retrospective study of cases within our trust - We will analyse the notes and anaesthetic charts of all elective c section cases in 2022 (phenylephrine group) and in 2024 (noradrenaline group) within the department. This will allow us to directly compare the use of phenylephrine and noradrenaline for the management of spinal hypotension following spinal anaesthesia in terms of both maternal and neonatal outcomes.
REC name
North East - Newcastle & North Tyneside 2 Research Ethics Committee
REC reference
24/NE/0228
Date of REC Opinion
19 Dec 2024
REC opinion
Further Information Favourable Opinion