Review Article

The Efficacy and Safety of Norepinephrine and Its Feasibility as a Replacement for Phenylephrine to Manage Maternal Hypotension during Elective Cesarean Delivery under Spinal Anesthesia

Table 3

Safety evaluation of norepinephrine.

ReferenceMaternal side effectsAnticholinergic drugApgar scoringBlood gas analysisUmbilical blood catecholamines

Hasanin et al., 2018 [2]Nausea or vomiting: nsFour in NE1, 3 in NE2, and 7 in NE3: nsApgar at 1 and 10 min: nspH, PCO2, PO2, HCO in UA: nsN/A

Sharkey et al., 2018 [10]Nausea or vomiting: nsN/AApgar at 1 and 5 min: nspH, PCO2, PO2, HCO3, BE in UA and UV: nsN/A

Ngan Kee et al., 2018 [3]Nausea or vomiting: nsNo patientNo Apgar < 7 at 1min or < 8 at 5min in either grouppH, PCO2, PO2, BE in UA and UV: nsN/A

Chen D et al., 2018, [4]Shivering, nausea, and pale skin: nsOne in NE3: nsApgar at 1 and 5 min: nsGlucose: NE2, NE3 > NE1, control group in either maternal or neonatal UA; pH, PCO2, PO2, HCO3, Lac, BE: ns among groups in maternal and neonatal UAN/A

Vallejo M et al., 2017 [7]Nausea: 51.2% for group NE and 63.2% for group PE, ns; emesis: 16.3% for group NE vs. 26.3% for group PE, nsN/AApgar < 7 at 1min or 5min: nspH, PCO2, PO2, HCO3, BE in UV: nsN/A

Onwochei et al., 2017 [5]Nausea: 11 (27.5%), of which 4 (36.4%) and 7 (63.6%) with NE < 6 μg and at 6 μg, respectively; no vomiting observedN/AAll Apgar > 8 at 1 min or 5 minIncidence of UA pH < 7.2: 6 (15%), 1 with NE < 6μg, 5 with NE 6 μg
BE is higher in those with NE < 6μg compared to those with 6 μg: -2.56 vs -4.94
N/A

Ngan Kee et al., 2017 [6]N/AN/AApgar < 7 at 1 min or < 8 at 5 min: nsIncidence of UA pH < 7.2: 4 (4.4%) vs 5(5.6%), nsN/A

Ngan Kee et al., 2015 [9]Nausea or vomiting: 3 (6.1%) for group NE and 2 (3.8%) for group PE, nsN/AAll Apgar > 7 at 1 min and 5 minNo patient had UA pH < 7.2
pH and oxygen content: group NE > PE in UV; PCO2, PO2, BE: ns in UV; pH, PCO2, PO2, BE, oxygen content, ns in UA
Glucose content: group NE > PE in UA and UV
Epinephrine content: group NE < PE in UA;
NE content: group NE < PE in UA and UV

BE: base excess; NE: norepinephrine; PE: phenylephrine; UA: umbilical artery; UV: umbilical vein; ns: no significant difference between or among groups; values are number (%); N/A: not available.