Optimal dose of prophylactic intravenous ephedrine for spinal-induced hypotension during cesarean section

ABSTRACT

The objective of this study was to compare the efficacy of 10, 15, and 20mg bolus doses of prophylactic IV ephedrine for prevention of maternal hypotension associated with spinal anesthesia for cesarean section. A prospective, quasi experimental study. The study was conducted at Department of Anesthesiology and Intensive Care, Shalamar Hospital Lahore [Pakistan], and was completed in six months period from January to June 2008. Ninety parturients of ASA grade I and II, receiving spinal anesthesia for elective C-section were included in this study. They were randomly divided into three groups. Group-I received lOmg, Group-II 15mg, and Group-Ill 20mg prophylactic IV ephedrine immediately after administration of spinal anesthesia. Intra operative hemodynamic changes were recorded and the data were analyzed. Incidence of hypotension was significantly higher in Group-I parturients receiving a lOmg prophylactic dose of ephedrine than in Group-II and Group-Ill parturients receiving 15mg or 20mg of ephedrine respectively [53.3% versus 13.3% and 3.3% respectively]. There was however, a significantly higher incidence of reactive hypertension in Group-II parturients [46.7%]. 15mg bolus dose of prophylactic IV ephedrine can effectively prevent spinal induced maternal hypotension during cesarean section without adverse effects like reactive hypertension