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. 2020 Jul 1;2020(7):CD002251. doi: 10.1002/14651858.CD002251.pub4

Chan 1997.

Study characteristics
Methods RCT
Participants 46 women
Inclusion criteria: healthy parturients with normal pregnancies undergoing elective CS at term
Exclusion criteria: not specified
Setting: China
Interventions Prophylactic ephedrine versus crystalloid preload
Group 1: ephedrine 0.25 mg/kg in 5 mL normal saline over 3 min immediately after spinal injection
Group 2: Hartmann's solution 20 mL/kg 10‐15 min prior to spinal injection
Standardised spinal anaesthetic technique and dose
Outcomes Maternal: hypotension); level of sensory block; Doppler ultrasound uterine blood flow measurements before and 5 min after spinal injection; nausea and vomiting; shivering; cardiac dysrhythmia; uterine incision‐birth time
Neonatal: arterial and venous cord blood gases; Apgar scores at 1 min and 5 min
Notes Hypotension defined as a decrease in systolic pressure of > 20% of baseline
Risk of bias
Bias Authors' judgement Support for judgement
Random sequence generation (selection bias) Unclear risk "Randomly assigned": method not described
Allocation concealment (selection bias) Unclear risk Method not described
Blinding of participants and personnel (performance bias)
All outcomes Unclear risk Neonatal assessment only (a preoperative Doppler ultrasound of uterine blood flow conducted by obstetrician who was blinded to the "treatment received") – no further details
Blinding of outcome assessment (detection bias)
All outcomes Unclear risk Methods not described
Incomplete outcome data (attrition bias)
All outcomes Low risk Losses to follow‐up: none
Selective reporting (reporting bias) Unclear risk Most expected outcomes reported
Other bias Low risk Similar baseline characteristics