Does Bolus-Dose Phenylephrine Cause Hypertension or Bradycardia in Emergency Department Patients?

Bolus-dose phenylephrine at a dose of roughly ½ mg (500 μg) is a convenient way to support an emergency department (ED) patient's blood pressure while more-definitive measures are being prepared. But is it safe? Investigators reviewed charts at a single academic ED to determine whether patients had hypertension or reflex bradycardia after receiving bolus-dose phenylephrine. The ED had systematically facilitated the practice by providing prefilled syringes with 1 mg phenylephrine in 10 mL saline.

Among 181charts reviewed, there were no serious adverse events. There were five mild adverse events: three cases of hypertension (systolic blood pressure >180 mm Hg) and two of bradycardia (heart rate <50 beats per minute) within 30 minutes of phenyl…