EFFICACY OF ETILEFRINE AND NOREPINEPHRINE IN PREVENTING MATERNAL HYPOTENSION DURING CESAREAN SECTION UNDER SPINAL ANESTHESIA: AN OBSERVATIONAL STUDY

Paola Pratolongo Perez M.; Dayang Vásquez Yeng J.; Renato Moreno Gonzales Á.; Isabel López Vidal R.; Antonio Campaña Acuña A. · Revista de la Facultad de Medicina Humana (2025) · DOI: 10.25176/rfmh.v25i1.7296

Resumen

Introduction: Maternal hypotension is a common complication of spinal anesthesia during cesarean section, affecting hemodynamic stability and fetal well-being. Objectives: To compare the efficacy of etilefrine versus norepinephrine (administered as a bolus or continuous infusion) in preventing maternal hypotension during cesarean section. Methods: A prospective observational study was conducted on 300 pregnant women undergoing cesarean section under spinal anesthesia, divided into three groups according to the vasopressor administered: etilefrine bolus (EB), norepinephrine bolus (NB), and norepinephrine continuous infusion (NCI). The incidence of hypotension, systolic and mean arterial pressure, heart rate, and Apgar scores were measured. Statistical analysis included ANOVA and propensity score matching to control for baseline differences. Results: The NCI group showed a significant reduction in the incidence of maternal hypotension (23%) compared to EB (62%) and NB (68%) (p<0.001), with an absolute decrease of 1.36 episodes compared to EB (p=0.003) and 1.24 episodes compared to NB (p<0.001). In relative terms, this corresponded to a 35% and 47% reduction, respectively. No significant differences were found in Apgar scores (p=0.720), with one-minute values of 7.87 (EB), 8.00 (NB), and 8.02 (NCI), and five-minute values of 8.91 (EB), 9.00 (NB), and 9.00 (NCI). Conclusion: Continuous infusion of norepinephrine is more effective than etilefrine and norepinephrine bolus in preventing maternal hypotension during cesarean section under spinal anesthesia.

Instituciones: Universidad Científica del Sur