Dose of prophylactic intravenous ephedrine during spinal anesthesia for cesarean section.
OBJECTIVE
To compare the incidence of maternal hypotension associated with spinal anesthesia for cesarean section when 10-, 15-, or 20-mg prophylactic boluses of intravenous (IV) ephedrine are used.


METHODS
Prospective observational study.


METHODS
Teaching hospital.


METHODS
108 women admitted for elective cesarean section.


METHODS
Spinal anesthesia was performed using hyperbaric bupivacaine 10 mg, sufentanil 2 microg, and morphine 0.2 mg (volume 4 mL). Ephedrine (10, 15, or 20 mg) was administered 2 minutes after the intrathecal injection. Maternal blood pressure was checked every 2 minutes. Hypotension was promptly treated with 5-mg ephedrine boluses.


RESULTS
Incidence of hypotension was significantly higher in women receiving a 10-mg prophylactic dose of ephedrine than in those receiving either a 15-mg or a 20-mg prophylactic dose of ephedrine [23/36 in the 10-mg ephedrine group vs. 13/36 and 10/36 in the 15-mg and 20-mg ephedrine groups, respectively (p< 0.05)].


CONCLUSIONS
In the conditions of this study, a single bolus of IV ephedrine with doses of either 15 or 20 mg decreased significantly the incidence of maternal hypotension as compared to a single 10-mg bolus of ephedrine.
Simon
L
L
Service d' Anesthésie-Réanimation, Hôpital Saint-Vincent de Paul, Paris, France. mater.anesthesie@svp.ap-hop-paris.fr
Provenchère
S
S
de Saint Blanquat
L
L
Boulay
G
G
Hamza
J
J
D000328:Adult; D000767:Anesthesia, Epidural / Q000009:adverse effects*; D000773:Anesthesia, Obstetrical / Q000009:adverse effects*; D001034:Apgar Score; D001794:Blood Pressure / Q000187:drug effects; D002585:Cesarean Section; D004809:Ephedrine / Q000008:administration & dosage / Q000627:therapeutic use*; D005260:Female; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D007022:Hypotension / Q000139:chemically induced / Q000517:prevention & control*; D007231:Infant, Newborn; D007275:Injections, Intravenous; D011247:Pregnancy; D011446:Prospective Studies; D014662:Vasoconstrictor Agents / Q000008:administration & dosage / Q000627:therapeutic use*
D014662:Vasoconstrictor Agents; D004809:Ephedrine