Most Read Articles
Rachel Soon, 5 days ago

On 8 August, the first town hall held by the Ministry of Health (MOH) with members of the pharmacy profession took place in Putrajaya. Over 500 pharmacists from across the country and from different areas of practice—community and hospital, public and private, academy and industry—converged to fill the auditorium for the chance to engage in direct dialogue with MOH.

Stephen Padilla, 6 days ago
Early administration of recombinant human B-type natriuretic peptide (rhBNP) can lower the incidence of reperfusion injury for patients with ST-elevation myocardial infarction (STEMI) who are receiving percutaneous coronary intervention (PCI) treatment, according to a China study.
11 Aug 2019
Intraoperative methylprednisolone does not appear to significantly prevent the incidence of death, cardiac arrest and other injuries in neonates undergoing cardiac surgery with cardiopulmonary bypass, according to a recent study.
3 days ago
Pulmonary function has potential predictive value for future increases in arterial stiffness and its progression, as reported in a recent study.

Metaraminol trumps ephedrine for elective caesarean

21 Jul 2019

Metaraminol may be a better vasopressor than ephedrine for mothers undergoing elective caesarean section, a recent meta-analysis has found.

Accessing the databases of PubMed, Embase and the Cochrane Library, researchers retrieved four randomized controlled trials that compared metaraminol with other vasopressors for spinal anaesthesia during caesarean delivery. The cumulative sample included 409 participants.

Relative to ephedrine, metaraminol resulted in a higher mean umbilical arterial pH (standardized mean difference [SMD], 0.82, 95 percent CI, 0.01–1.62; p=0.05) and a lower incidence of arterial pH <7.2 (risk ratio [RR], 0.08, 0.01–0.63; p=0.02). Nauseous vomiting was also significantly lower in those treated with metaraminol (RR, 0.16, 0.04–0.57; p=0.005).

In contrast, both vasopressors yielded comparable incidence rates of Apgar scores <7 at 1 minute (RR, 0.62, 0.08–4.85; p=0.65), hypotension (RR, 0.56, 0.26–1.17; p=0.12) and hypertension (RR, 1.44, 0.82–2.54; p=0.20).

When compared with phenylephrine, metaraminol resulted in a higher mean umbilical arterial pH (SMD, 0.42, 0.15–0.68; p=0.002) and incidence rate of hypertension (RR, 1.80, 1.32–2.46; p=0.0002).

No differences were observed for the incidence rate of umbilical pH <7.2 (RR, 0.18, 0.02–1.48; p=0.11), Apgar scores <7 at 1 minute (RR, 0.40, 0.11–1.45; p=0.16), hypotension (RR, 0.80, 0.53–1.22; p=0.30), or nausea or vomiting (RR, 0.53, 0.16–1.73; p=0.29).

Overall, prophylactic metaraminol appears to be superior to ephedrine for elective caesarean section delivery, while being at least not inferior to phenylephrine, said researchers. There is a need for further studies to facilitate the selection of the optimal vasopressor.

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Most Read Articles
Rachel Soon, 5 days ago

On 8 August, the first town hall held by the Ministry of Health (MOH) with members of the pharmacy profession took place in Putrajaya. Over 500 pharmacists from across the country and from different areas of practice—community and hospital, public and private, academy and industry—converged to fill the auditorium for the chance to engage in direct dialogue with MOH.

Stephen Padilla, 6 days ago
Early administration of recombinant human B-type natriuretic peptide (rhBNP) can lower the incidence of reperfusion injury for patients with ST-elevation myocardial infarction (STEMI) who are receiving percutaneous coronary intervention (PCI) treatment, according to a China study.
11 Aug 2019
Intraoperative methylprednisolone does not appear to significantly prevent the incidence of death, cardiac arrest and other injuries in neonates undergoing cardiac surgery with cardiopulmonary bypass, according to a recent study.
3 days ago
Pulmonary function has potential predictive value for future increases in arterial stiffness and its progression, as reported in a recent study.