A Systematic Review of Phenylephrine Versus Noradrenaline for the Management of Hypotension Associated With Neuraxial Anesthesia in Women Undergoing Cesarean Section

( Anaesthesia . 2020;75:800–808) Up to 60% of women who receive spinal anesthesia during cesarean delivery experience hypotension. Phenylephrine has become the vasopressor of choice but is associated with maternal reflex bradycardia. Noradrenaline is an alternative vasopressor and is associated less with bradycardia. Noradrenaline has weak β-adrenergic activity and some studies have suggested noradrenaline is associated with fetal acidosis. This review aimed to identify randomized controlled trials comparing the use of noradrenaline and phenylephrine in women receiving spinal anesthesia for cesarean delivery.