A commonly used approach to manage hypotension during neuraxial block?

• A. Increase turning off vasopressors.
• B. Administer vasopressors.
• C. Delay treatment until delivery.
• D. Use diuretics.

Answer: (B)

Hypotension from neuraxial anesthesia occurs because blocking sympathetic nerves leads to vasodilation and pooling of blood in the venous system, reducing venous return and arterial pressure. The most effective and standard way to counter this is to give vasopressors. They tighten the blood vessels and increase systemic vascular resistance, quickly restoring mean arterial pressure and improving uteroplacental perfusion. While fluids can help, they’re usually not enough on their own, and vasopressor therapy is the mainstay of treatment. Delaying treatment until delivery risks fetal distress, and diuretics would worsen the hypotension by decreasing intravascular volume. In practice, agents like phenylephrine are commonly used, with others such as ephedrine available depending on clinical factors.