Effect of Phenylephrine Rescue Injection on Hypotension After Spinal Anaesthesia for Caesarean Delivery When Guided by Both Heart Rate and SBP During an Early Warning Window: A Randomised Controlled Trial

( Eur J Anaesthesiol . 2024;41(6):421–429. doi:10.1097/EJA.0000000000001977) Some previous studies have determined that spinal anesthesia in cesarean births followed by hypotension comes with an increase in heart rate. However, the increase in heart rate can usually be seen before the drop in blood pressure from hypotension because heart rate is continually monitored, and blood pressure is monitored intermittently. Because providing rescue injections and adjusting infusion speed after spinal anesthesia in cesarean births to manage hypotension is a reactive management tool and may be delayed because of instrumentation delays, overt hypotension or reactive hypertension sometimes results. The authors of this study previously studied administering phenylephrine rescue injections because of an increase in heart rate instead of when a drop in blood pressure is seen and subsequently pausing or reducing a phenylephrine infusion because of a drop in heart rate, as this indicates a recovery from hypotension. This study aimed to test using heart rate and BP as hypotension indicators in a clinical setting using a randomized, controlled, prospective, and single-blind study.