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The effects of intravenous ephedrine during spinal anesthesia for cesarean delivery: a randomized controlled trial.

Author(s): Kol IO, Kaygusuz K, Gursoy S, Cetin A, Kahramanoglu Z, Ozkan F, Mimaroglu C

Affiliation(s): Department of Anesthesiology, Cumhuriyet University School of Medicine, Sivas, Turkey. driclal@gmail.com

Publication date & source: 2009-10, J Korean Med Sci., 24(5):883-8. Epub 2009 Sep 23.

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.

Page last updated: 2009-10-20

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