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dc.contributor.authorKetchada Uerpairojkiten_US
dc.contributor.authorNutnicha Thongthaweepornen_US
dc.contributor.authorRatikorn Anusorntanawaten_US
dc.contributor.authorTanyong Pipanmekapornen_US
dc.contributor.authorThanoo Hinthongen_US
dc.contributor.authorNutchanart Bunchungmongkolen_US
dc.contributor.authorNawaporn Simarangsanen_US
dc.date.accessioned2022-10-16T07:03:35Z-
dc.date.available2022-10-16T07:03:35Z-
dc.date.issued2022-07-01en_US
dc.identifier.issn14470756en_US
dc.identifier.issn13418076en_US
dc.identifier.other2-s2.0-85130472715en_US
dc.identifier.other10.1111/jog.15289en_US
dc.identifier.urihttps://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85130472715&origin=inwarden_US
dc.identifier.urihttp://cmuir.cmu.ac.th/jspui/handle/6653943832/75909-
dc.description.abstractAim: To compare incidences of abnormal heart rate (HR) between the phenylephrine/ephedrine protocol (P/E protocol) against the ephedrine-only (C) protocol, conventionally used for treating predelivery hypotension following spinal anesthesia for cesarean section. Methods: Two hundred and sixty-eight parturients with pre-delivery hypotension after spinal anesthesia were equally randomized to (1) Group P/E (n = 134), phenylephrine 100 mcg in 10 mL intravenously if HR ≥ 60 beats/min (bpm), or ephedrine 6 mg intravenously if HR < 60 bpm, and 2) Group C (n = 134). The primary outcome was the incidence of the parturients with abnormal HR after vasopressor administration. The secondary outcome was the mean differences of HR and hypotensive periods during the pre-delivery period. Results: There was no significant difference of between-group incidences of bradycardia (12.0% in Group P/E vs 6.7% in Group C, p = 0.136) and tachycardia (26.9% vs 35.8%, p = 0.114). Mean HR was 81.9 bpm (95% confidence interval [CI] 79.9, 84.3) in Group P/E, and 88.8 bpm (86.8, 90.6) in Group C (p < 0.001). The duration of hypotension in relation to the time interval from spinal anesthesia to delivery was 20.9% (95% CI 18.4–23.2) in Group P/E, and 26.5% (23.9–29.3) in Group C (p < 0.01). The calculated area under the curve (AUC) of abnormal HR in relation to time was significantly reduced only in Group P/E (p < 0.010). Conclusions: The incidences of out-of-range HR were comparable, but the P/E protocol resulted in a lower mean HR and better control of systolic blood pressure than the ephedrine-only protocol.en_US
dc.subjectMedicineen_US
dc.titleA randomized comparison of hemodynamic changes in response to a heart rate-dependent phenylephrine/ephedrine protocol versus ephedrine-only for spinal hypotension during elective cesarean sectionen_US
dc.typeJournalen_US
article.title.sourcetitleJournal of Obstetrics and Gynaecology Researchen_US
article.volume48en_US
article.stream.affiliationsFaculty of Medicine, Chulalongkorn Universityen_US
article.stream.affiliationsChiang Mai Universityen_US
article.stream.affiliationsSamutprakarn Hospitalen_US
article.stream.affiliationsChaophraya Yommarat Hospitalen_US
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