Comparison of an ephedrine infusion with crystalloid administration for prevention of hypotension during spinal anesthesia.
This study was designed to compare the efficacy of an ephedrine infusion with crystalloid administration for reducing the incidence of hypotension during spinal anesthesia. Fifty-four ASA I patients scheduled for postpartum tubal ligations under spinal anesthesia were randomly allocated to receive either 15 mL/kg of crystalloid (crystalloid group) or an ephedrine infusion (infusion group). Spinal anesthesia was performed using 70-90 mg of hyperbaric 5% lidocaine. Patients in the infusion group immediately thereafter received an ephedrine infusion at a rate of 5 mg/min for the first 2 min and then 1 mg/min for the next 18 min. The incidence of hypotension was 15/27 (55%) in the crystalloid group and 6/27 (22%) in the infusion group (P < 0.05). There was no significant difference between the groups in relation to the level of anesthesia or maximal heart rate, and hypertension did not occur in either group. We conclude that a prophylactic ephedrine infusion is effective for minimizing and managing hypotension associated with spinal anesthesia and compares favorably with crystalloid administration in this patient population in terms of efficacy and incidence of side effects.
Gajraj
N M
NM
Department of Anesthesiology and Pain Management, University of Texas Southwestern Medical School, Dallas 75235-9068.
Victory
R A
RA
Pace
N A
NA
Van Elstraete
A C
AC
Wallace
D H
DH
D000328:Adult; D000775:Anesthesia, Spinal / Q000379:methods*; D000077324:Crystalloid Solutions; D004809:Ephedrine / Q000008:administration & dosage / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007022:Hypotension / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*; D007552:Isotonic Solutions; D010952:Plasma Substitutes / Q000008:administration & dosage / Q000627:therapeutic use*; D013246:Sterilization, Tubal
D000077324:Crystalloid Solutions; D007552:Isotonic Solutions; D010952:Plasma Substitutes; D004809:Ephedrine