Norepinephrine has recently been increasingly studied for prophylaxis against hypotension during Cesarean Section under spinal anesthesia.
Phenylephrine has been shown to ameliorate hypotension and nausea/vomiting when given as a prophylactic infusion following spinal anesthesia.
This study compared the two agents and found Norepinephrine infusion effective and associated with less reactive hypertension and bradycardia. Neonatal outcomes were the same.
Norepinephrine rates were started at 0.05 mcg/Kg/min and Phenylephrine at 0.75 mcg/Kg/min.
This adds to growing evidence for Norepinephrine as an option in this scenario.