title: The effects of ephedrine on maternal hypothermia in caesarean sections: a double blind randomized clinical trial.
abstract: BACKGROUND
  The purpose of the study was to investigate the effect of bolus and the combination of bolus and infusion of ephedrine on maternal hypothermia which are used for treating maternal hypotension under spinal anaesthesia.
  
  
  METHODS
  110 ASA I-II patients who developed maternal hypotension were included into the study. Spinal anaesthesia was performed with 12.5 mg heavy bupivacaine + 15 µg fentanyl. Group I: Ephedrine bolus 5 mg plus ephedrine infusion, Group B: Ephedrine bolus 5 mg plus normal saline infusion. The systolic blood pressure was allowed to range between 20% from baseline values. Ephedrine solution infusion started after hypotension occurred (0.5 mg/minute). The body temperature under 35.5°C was accepted as hypothermia. The newborns' rectal temperature was measured. Moreover, the Apgar scores, umbilical vein-arterial blood gas and acid-base status were evaluated.
  
  
  RESULTS
  In Group I, the body core temperatures which were measured at 9, 18, 33, and 39th minutes were significantly higher than Group B (p < 0.05). The prevalence of maternal hypothermia in Group I was significantly lower than the Group B, which were as 65.5% (36/55) and 85.5% (47/55), respectively (p < 0.05). In Group I, the newborn rectal temperatures and the total dose of ephedrine were significantly higher than Group B (p < 0.05). In Group I, the systolic and mean blood pressures were higher than Group B (p < 0.05).
  
  
  CONCLUSIONS
  As a result, we found that combined bolus and infusion of ephedrine for treating maternal hypotension prevents maternal and neonatal hypothermia during caesarean section under spinal anaesthesia compared to bolus administrations alone.
authors.affiliation: Department of Anaesthesiology, and Department of Biostatistics; School of Medicine, Inonu University, Malatya, Turkey. nurcin.gulhas@inonu.edu.tr  
authors.forename: N
authors.initials: N
authors.lastname: Gulhas
authors.forename: D
authors.initials: D
authors.lastname: Tekdemir
authors.forename: M
authors.initials: M
authors.lastname: Durmus
authors.forename: A
authors.initials: A
authors.lastname: Yucel
authors.forename: F A
authors.initials: FA
authors.lastname: Erdil
authors.forename: S
authors.initials: S
authors.lastname: Yologlu
authors.forename: M O
authors.initials: MO
authors.lastname: Ersoy
mesh_terms: D061605:Administration, Intravenous; D000328:Adult; D000775:Anesthesia, Spinal / Q000009:adverse effects; D001831:Body Temperature / Q000187:drug effects; D002585:Cesarean Section; D004311:Double-Blind Method; D004809:Ephedrine / Q000008:administration & dosage* / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007022:Hypotension / Q000188:drug therapy* / Q000209:etiology; D007035:Hypothermia / Q000517:prevention & control*; D011247:Pregnancy; D014662:Vasoconstrictor Agents / Q000008:administration & dosage* / Q000627:therapeutic use; D055815:Young Adult
chemical_list: D014662:Vasoconstrictor Agents; D004809:Ephedrine