The effect of preoperative anxiety on phenylephrine dose during cesarean delivery: An open controlled one‐arm clinical trial

• Published in: Acta anaesthesiologica Scandinavica Vol. 64; no. 10; pp. 1499 - 1504
• Main Authors: Danon, Eran, Heesen, Philip, Orbach‐Zinger, Sharon, Kornilov, Evgeniya, Ronen, Ariel, Weiniger, Carolyn, Eidelman, Leonid
• Format: Journal Article
• Language: English
• Published: England Wiley Subscription Services, Inc 01-11-2020
• Subjects: Anesthesia; Anesthesia, Obstetrical; Anesthesia, Spinal; Anxiety; Cesarean Section; Clinical trials; Dosage; Double-Blind Method; Female; Humans; Hypotension; Hypotension - drug therapy; Phenylephrine; Phenylephrine - therapeutic use; Pregnancy; Statistical analysis; Vasoconstrictor Agents - therapeutic use
• ISSN: 0001-5172; 1399-6576
• DOI: 10.1111/aas.13683

Background
We performed an open controlled one‐arm clinical trial to assess whether preoperative anxiety influences phenylephrine dosage required to maintain normotension during cesarean section under spinal anesthesia.
Methods
Ninety‐four parturients undergoing elective cesarean delivery under spinal anesthesia were included. Anxiety levels were measured using a verbal numerical scale anxiety score (0‐10). Phenylephrine infusion to prevent hypotension was adjusted by a standard algorithm. The primary outcome was total phenylephrine dose. Linear uni‐ and multivariate regressions were performed to assess the relationship between preoperative anxiety and the outcome. P < .05 was considered statistically significant.
Results
We found no association between preoperative anxiety and phenylephrine dosage (R2 = 0.05). Taking the number of attempts for spinal anesthesia and surgical time into account did not lead to a significant improvement of the regression model.
Conclusion
In conclusion, we did not find a large independent effect of preoperative anxiety on phenylephrine dose required to maintain normotension in our cohort. We believe that spinal hypotension and phenylephrine dose requirement are multifactorial and anxiety is only one of the factors in this complex interaction.