THE EFFECTS OF INTRAVENOUS EPHEDRINE DURING SPINAL ANESTHESIA FOR CESAREAN DELIVERY; A RANDOMIZED CONTROLLED TRIAL

Aktar Hossain (Ovi)*, Syed Nurul Huda, Khondaker Shaheen Hossain, Asadul Haque (Polash) and Monowar Hossain Talukder

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 gropes; ephedrine group, 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±5.4min) 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.

Keywords: Anesthesia, Spinal; Cesarean Section; Ephedrine; Hypotension.