Spinal-induced hypotension at caesarean section

Spinal-induced hypotension (SIH) is a common but potentially serious side effect of spinal anaesthetics during caesarean section, with potential maternal and fetal consequences. A number of non-pharmacological methods can be employed to reduce the incidence of SIH, including maternal positioning and fluids. However, these should be used in conjunction with pharmacological methods, which have been shown to be superior in reducing SIH. For many years phenylephrine has been the standard vasopressor in obstetrics, but emerging evidence indicates that there may be more appropriate pharmacological options, with a promising/recent focus on investigating noradrenaline.