Reduction of occurrence of hypotension during spinal anaesthesia for cesarean section: prophylactic intramuscular ephedrine versus fluid preload

ABSTRACT

In this study, 40 women undergoing elective cesarean surgery [CS] at term were allocated randomly to receive either a preload of 20 ml/kg of normal saline over 10-15 min immediately before spinal anesthesia [fluid group] or prophylactic ephedrine 50 mg in 10 min before spinal anesthesia [ephedrine group]. The two techniques were compared for their maternal and neonatal effects. Moderate hypotension was defined as >20% reduction in systolic blood pressure [SAP] and severe hypotension as >30% reduction in SAP. The study concluded that ephedrine e 50 mg given intramuscularly ten minutes before induction of spinal anesthesia reduced the incidence of hypotension and the total dose of rescue ephedrine therapy than preloading with 20 ml/kg crystalloid during spinal anesthesia for CS. The incidence of nausea and vomiting was also reduced and the fetal outcome was improved. However, this dose of ephedrine did not completely eliminate hypotension, nausea and vomiting