title: Ephedrine requirements are reduced during spinal anaesthesia for caesarean section in preeclampsia.
abstract: BACKGROUND
  Despite controversy over the haemodynamically safest blockade for caesarean section in women with severe preeclampsia, an increasing number of anaesthetists now opt for spinal anaesthesia. In a previous study we found that spinal compared to epidural anaesthesia offered an equally safe but more effective option for these patients. The current study was designed to compare the hypotension induced by spinal anaesthesia, as measured by ephedrine requirement, between 20 normotensive and 20 severely preeclamptic but haemodynamically stabilised women.
  
  
  METHODS
  Standardised spinal anaesthesia was instituted and ephedrine was given in boluses of 6 mg if the systolic pressure fell >20% from the baseline, or if the patient exhibited symptoms of hypotension.
  
  
  RESULTS
  The mean ephedrine requirement of the normotensive group (27.9+/-11.6 mg) was significantly greater (P<0.01) than that of the preeclamptic group (16.4+/-15.0 mg).
  
  
  CONCLUSIONS
  This suggests that the hypotension induced by spinal anaesthesia in women with severe but haemodynamically stabilised preeclampsia, is less than that of normotensive patients.
authors.affiliation: The Department of Anaesthesia, Simpson Centre for Reproductive Health, Edinburgh EH16 4SA, UK.
authors.forename: V A
authors.initials: VA
authors.lastname: Clark
authors.forename: G H
authors.initials: GH
authors.lastname: Sharwood-Smith
authors.forename: A V G
authors.initials: AV
authors.lastname: Stewart
mesh_terms: D000328:Adult; D000773:Anesthesia, Obstetrical; D000775:Anesthesia, Spinal; D001794:Blood Pressure / Q000187:drug effects; D002585:Cesarean Section; D004809:Ephedrine / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D011225:Pre-Eclampsia / Q000503:physiopathology*; D011247:Pregnancy
chemical_list: D004809:Ephedrine