title: Prophylactic oral ephedrine reduces the incidence of hypotension after subarachnoid block.
abstract: The purpose of this study was to demonstrate the efficacy of oral ephedrine in preventing hypotension following subarachnoid block. Two hundred women, ASA physical status I or II, undergoing lower abdominal surgery were randomly divided into two groups (n = 100 each). All patients were given routine oral premedication consisting of diazepam 10 mg and ranitidine 150 mg at bed time and at 90 min before surgery. In addition, Group I patients received ephedrine 30 mg, orally, 30 min before subarachnoid block was administered. Group II received only routine premedication. After starting an iv line and preloading with 10 ml.kg-1 crystalloid, patients were given 0.5% heavy bupivacaine 3.2 to 3.6 ml, depending on body weight, intrathecally. Patients with decreases in blood pressure of 20% were given ephedrine i.v., in increments, in addition to crystalloids. Despite a similar level of block (T3-T4) and i.v. fluids, the total dose of ephedrine supplement in Group I was 4.3 +/- 4.8 mg compared with 11.6 +/- 9.4 mg in Group II (P < 0.01). Also, 55 patients in Group I required intraoperative inotrope supplement compared with 83 in Group II (P < 0.01). We conclude that oral ephedrine premedication is a simple and effective way of reducing the incidence of hypotension in patients undergoing lower abdominal surgery under subarachnoid block.
authors: Om Nursing Home, Katmandu, Nepal.
authors: S K
authors: SK
authors: Kafle
authors: S M
authors: SM
authors: Malla
authors: B D
authors: BD
authors: Lekhak
mesh_terms: D000005:Abdomen / Q000601:surgery; D000284:Administration, Oral; D000328:Adult; D000775:Anesthesia, Spinal / Q000009:adverse effects*; D001794:Blood Pressure / Q000187:drug effects; D002045:Bupivacaine / Q000008:administration & dosage; D002316:Cardiotonic Agents / Q000627:therapeutic use; D003975:Diazepam / Q000008:administration & dosage; D004809:Ephedrine / Q000008:administration & dosage / Q000627:therapeutic use*; D005260:Female; D005440:Fluid Therapy; D006801:Humans; D007022:Hypotension / Q000517:prevention & control*; D016343:Monitoring, Intraoperative; D009407:Nerve Block / Q000009:adverse effects*; D011229:Preanesthetic Medication; D011292:Premedication; D011899:Ranitidine / Q000627:therapeutic use; D013346:Subarachnoid Space
chemical_list: D002316:Cardiotonic Agents; D011899:Ranitidine; D004809:Ephedrine; D003975:Diazepam; D002045:Bupivacaine