March 19, 2026 · Anaesthesia · DOI: 10.1111/anae.70204

Efficacy and safety of different vasopressor infusions on feto-maternal outcomes in normotensive patients undergoing caesarean delivery: a systematic review and network meta-analysis of randomised controlled trials

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The authors aimed to evaluate the efficacy and safety of various vasopressor infusions on feto-maternal outcomes in normotensive patients undergoing caesarean delivery, given the variability in clinical practice despite guidelines favoring phenylephrine. Their systematic review and network meta-analysis of 55 randomized controlled trials found that continuous infusions of α-agonists with mild β-activity, such as noradrenaline and metaraminol, were superior to control in preventing maternal hypotension, while mephentermine and metaraminol better preserved umbilical acid-base balance. However, they noted that the evidence regarding fetal outcomes remains limited.

Narinder Pal Singh, Jeetinder Kaur Makkar, Bisman Jeet Kaur Khurana, Anuradha Borle, Preet Mohinder Singh

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