J Korean Med Sci.  2009 Oct;24(5):883-888. 10.3346/jkms.2009.24.5.883.

The Effects of Intravenous Ephedrine During Spinal Anesthesia for Cesarean Delivery: A Randomized Controlled Trial

• Kol IO
• Kaygusuz K
• Gursoy S
• Cetin A
• Kahramanoglu Z
• Ozkan F
• Mimaroglu

• KMID: 1782011
• DOI: http://doi.org/10.3346/jkms.2009.24.5.883

Abstract

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.

Keyword

Anesthesia, Spinal; Cesarean Section; Ephedrine; Hypotension

MeSH Terms

Adult
*Anesthesia, Spinal/adverse effects
Blood Pressure/drug effects
*Cesarean Section
Ephedrine/administration & dosage/*therapeutic use
Female
Heart Rate/drug effects
Humans
Hypotension/chemically induced/prevention & control
Injections, Intravenous
Postoperative Nausea and Vomiting/prevention & control
Pregnancy
Vasoconstrictor Agents/administration & dosage/*therapeutic use

Figure

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  Fig. 1 Baseline, the lowest, and highest systolic arterial pressure (SAP) and heart rate (HR) of the study groups. Values are mean±SD. *P<0.05 vs. control group.

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  Fig. 2 Systolic arterial pressure of the ephedrine and control groups. Values are mean±SD. *P<0.05 vs. control group; †P<0.05 vs. baseline.

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  Fig. 3 Heart rate of the ephedrine and control groups. Values are mean±SD. *P<0.05 vs. control group.

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