The effects of intravenous ephedrine during spinal anesthesia for cesarean delivery: a randomized controlled trial.
We designed a randomized, double-blinded study to determine the efficacy and safety of 0.5 mg/kg intravenous ephedrine for the prevention of hypotension during spinal anesthesia for cesarean delivery. Patients were randomly allocated into two groups: ephedrine group (n=21) and control group (n=21). Intravenous preload of 15 mL/kg lactated Ringer's solution was given. Shortly after the spinal injection, ephedrine 0.5 mg/kg or saline was injected intravenous for 60 sec. The mean of highest and lowest heart rate in the ephedrine group was higher than those of control group (P<0.05). There were significant lower incidences of hypotension and nausea and vomiting in the ephedrine group compared with the control group (8 [38.1%] vs. 18 [85.7%]); (4 [19%] vs. 12 [57.1%], respectively) (P<0.05). The first rescue ephedrine time in the ephedrine group was significantly longer (14.9+/-7.1 min vs. 7.9+/-5.4 min) than that of the control group (P<0.05). Neonatal outcome were similar between the study groups. These findings suggest, the prophylactic bolus dose of 0.5 mg/kg intravenous ephedrine given at the time of intrathecal block after a crystalloid fluid preload, plus rescue boluses reduce the incidence of hypotension.
Department of Anesthesiology, Cumhuriyet University School of Medicine, Sivas, Turkey. driclal@gmail.com
Iclal Ozdemir
IO
Kol
Kenan
K
Kaygusuz
Sinan
S
Gursoy
Ali
A
Cetin
Zeki
Z
Kahramanoglu
Fikret
F
Ozkan
Caner
C
Mimaroglu
D000328:Adult; D000775:Anesthesia, Spinal / Q000009:adverse effects; 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; D007275:Injections, Intravenous; D020250:Postoperative Nausea and Vomiting / Q000517:prevention & control; D011247:Pregnancy; D014662:Vasoconstrictor Agents / Q000008:administration & dosage / Q000627:therapeutic use*
D014662:Vasoconstrictor Agents; D004809:Ephedrine