Influence of hyperlipidemia factor on ephedrine-treated hypotension in patients undergoing epidural anesthesia / 中华麻醉学杂志

ABSTRACT

Objective To evaluate the influence of hyperlipidemia factor on ephedrine-treated hy-potension in the patients undergoing epidural anesthesia. Methods Patients scheduled for elective hyster-ectomy with epidural anesthesia, were divided into normal blood lipid group and hyperlipidemia group ac-cording to the fasting blood lipid level. Epidural puncture was performed at L1,2after replacing the cumula-tive body fluid loss. The hypotensive response was defined as decrease in systolic pressure (SP)＜80% of the baseline value or SP＜90 mmHg. Effective pressor response was defined as increase in SP＞90% of the baseline value or SP＞100 mmHg.The initial dose of ephedrine was 0. 10 mg∕kg.Up-and-down sequential al-location was used to determine the dose of ephedrine. The difference between two successive doses was 0. 02 mg∕kg. Each time the dose increased∕decreased in the next patient according to whether SP increased or not. Probit analysis was used to determine the ED50, and 95% confidence interval (CI) of ephedrine in treating hypotension. Results A total of 114 patients were enrolled in this study, with 64 cases in normal blood lipid group and 50 cases in hyperlipidemia group. The rate of epidural anesthesia-induced hypotension was 22%(14 cases) in normal blood lipid group and 40%(20 cases) in hyperlipidemia group, and there was significant difference between two groups (P＜0. 05). The ED50(95% CI) of ephedrine in treating hypoten-sion was 0. 81 (0. 75-1. 03) mg∕kg and 1. 14 (1. 05-1. 31) mg∕kg in normal blood lipid group and hyper-lipidemia group, respectively, and there was significant difference between two groups ( P＜0. 05). Con-clusion Hyperlipidemia can not only be considered as a risk factor for epidural anesthesia-induced hypo-tension, but also markedly decease pressor responses to ephedrine for the female patients undergoing low epidural anesthesia.