Loughrey 2005.

Study characteristics
Methods	RCT
Participants	43 women Inclusion criteria: ASA I and II non‐labouring women undergoing scheduled elective caesareans; term uncomplicated singleton pregnancies, women taking only prenatal vitamins and weighing less than 100 kg Exclusion criteria: cardiac, pulmonary or renal diseases or systemic diseases that could influence haemodynamic responses, including pre‐eclampsia, hypertension and diabetes; if women were taking or had a history of taking any medications that could influence haemodynamic responses, including magnesium sulphate, terbutaline or B‐blockers
Interventions	Phenylephrine versus control Group 1: 10 mg ephedrine IV Group 2: 40 µg phenylephrine + 10 mg ephedrine The IV bolus of study drug was administered simultaneously with the intrathecal anaesthetic injection. All women received a standardised crystalloid preload, did not wear thromboembolic stockings and received a standardised spinal anaesthetic technique and dose. IV preload with 10 mL/kg of Ringer's lactate; and 10mg IV ephedrine administered simultaneously with study drug For rescue from hypotension, women in the ephedrine only group were given 5 mg ephedrine and women in the ephedrine + phenylephrine group were given 5 mg ephedrine + 20 µg phenylephrine.
Outcomes	Maternal: hypotension; heart rate; nausea; rescue boluses; total mean ephedrine dose; total mean phenylephrine dose Neonatal: umbilical artery pH (mean and SD); umbilical vein pH (mean and SD); Apgar scores at 1 min and 5 min
Notes	Hypotension was defined as SBP < 100 mmHg or a decrease in SBP of 20% from baseline
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Unclear risk	Method not described
Allocation concealment (selection bias)	Unclear risk	"Sealed envelope"
Blinding of participants and personnel (performance bias) All outcomes	Low risk	Blinding: "double‐blinded"; anaesthetist remained blinded to the study solution throughout
Blinding of outcome assessment (detection bias) All outcomes	Low risk	As above
Incomplete outcome data (attrition bias) All outcomes	Unclear risk	Losses to follow‐up: 3/43 – 1 woman in the ephedrine only group and 2 in the ephedrine/phenylephrine group were excluded from analysis due to improper data collection before unblinding
Selective reporting (reporting bias)	Low risk	None apparent
Other bias	Low risk	None apparent