A healthy 26-year-old woman undergoing elective caesarean section under spinal anaesthesia develops hypotension with a blood pressure of 80/50 mmHg. According to standard Indian anaesthesia teaching, the traditional vasopressor of choice in this setting, because it maintains uteroplacental perfusion better than pure alpha agonists, is:
- A Ephedrine ✓
- B Norepinephrine
- C Phenylephrine
- D Mephentermine
Correct answer: A. Ephedrine
Explanation
Ephedrine is a mixed-acting sympathomimetic with predominantly indirect action plus some direct beta and alpha effects. Its cardiac output raising effect increases maternal blood pressure without the marked reduction in uteroplacental blood flow produced by pure alpha agonists, so it has been the classic drug of choice for spinal hypotension in obstetrics. Phenylephrine, though now increasingly used internationally, constricts the placental bed through unopposed alpha-1 stimulation.
Reference: Katzung's Basic and Clinical Pharmacology, 15th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.