Comparing norepinephrine and phenylephrine to prevent low blood pressure during spinal anesthesia in emergency cesarean sections

COMPARISON BETWEEN EFFICACY OF NOREPINEPHRINE AND PHENYLEPHRINE BOLUSES FOR PREVENTION OF SPINAL ANAESTHESIA INDUCED HYPOTENSION IN OBSTETRICAL PATIENTS UNDERGOING EMERGENCY CESAREAN SECTION- A Double Blind Randomized Controlled Trial

Not applicable Interventional Dow University of Health Sciences · NCT06836986

This study is testing whether norepinephrine works better than phenylephrine to prevent low blood pressure in pregnant women having emergency cesarean sections.

Quick facts

PhaseNot applicable
Study typeInterventional
Enrollment124 (estimated)
Ages18 Years to 40 Years
SexFemale
SponsorDow University of Health Sciences Academic / other
Locations1 site (Karachi, Sindh)
Trial IDNCT06836986 on ClinicalTrials.gov

What this trial studies

This clinical trial aims to determine whether norepinephrine is more effective than phenylephrine in preventing spinal anesthesia induced hypotension in obstetrical patients undergoing emergency cesarean sections. Participants will receive prophylactic boluses of both medications immediately after spinal anesthesia induction, and their hemodynamic parameters and neonatal APGAR scores will be monitored. The study is conducted at the K.M. Pfau Civil Hospital in Karachi, Pakistan, with data collected following ethical approval and informed consent. Randomization of participants will be performed using a lottery method to ensure unbiased results.

Who should consider this trial

Good fit: Ideal candidates for this study are obstetrical patients aged 18-40 years, classified as ASA II and III, with a gestational age of 32 weeks or more.

Not a fit: Patients with hypertensive disorders of pregnancy, significant cardiovascular or neurological diseases, or those requiring immediate general anesthesia may not benefit from this study.

Why it matters

Potential benefit: If successful, this study could lead to improved management of spinal anesthesia induced hypotension, enhancing maternal and neonatal outcomes during emergency cesarean sections.

How similar studies have performed: While the use of vasopressors in managing spinal anesthesia induced hypotension is established, this specific comparison of norepinephrine and phenylephrine is novel and has not been extensively tested.

Eligibility criteria

Show full inclusion / exclusion criteria
Inclusion Criteria:

1. American society of anesthesiologists II and III patients
2. Age 18-40years
3. Gestational age 32 weeks and above

Exclusion Criteria:

1. Patients with hypertensive disorders of pregnancy having baseline systolic blood pressure greater than 160 mmHg and diastolic blood pressure greater than 99 mmHg.
2. Baseline mean arterial pressure less than 70 mmHg.
3. Antepartum hemorrhage/intraoperative blood loss greater than 1000ml
4. history indicative of cardiovascular or neurological disease.
5. known fetal abnormality.
6. Patients taking serotonin reuptake inhibitor, Tricyclic antidepressants,monoamine oxidase inhibitors.
7. Maternal situations requiring immediate administration of general anesthesia

Where this trial is running

Karachi, Sindh

Study contacts

How to participate

  1. Review the eligibility criteria above with your treating physician.
  2. Visit the official trial page on ClinicalTrials.gov for the most current contact information and recruitment status.
  3. Contact the listed study coordinator or principal investigator to request pre-screening. Pre-screening is free and never obligates you to enroll.
Conditions Spinal Anesthesia Induced HypotensionSpinal anesthesia induced hypotensionEmergency lower segment cesarean sectionNorepinephrine bolusProphylacticPhenylephrine
Last reviewed 2026-06-13 by the Find a Trial editorial team. Information on this page is for educational purposes and is not medical advice. Always consult qualified healthcare professionals about clinical trial participation.