Comparison of effects of ephedrine and phenylephrine on hemodynamics in patients undergoing surgery in prone position under general anesthesia / 中华麻醉学杂志

ABSTRACT

Objective To compare the effects of ephedrine and phenylephrine on hemodynamics in the patients undergoing surgery in prone position under general anesthesia.Methods Sixty American Society of Anesthesiologists physical status Ⅰ or Ⅱ patients, aged 20-60 yr, with body mass index of 18.5-25.0 kg/m2, scheduled for elective posterior lumbar interbody fusion under general anesthesia, were randomized to ephedrine group (group E, n =30) or phenylephrine group (group P, n =30).When hypotension [decrease in systolic blood pressure (SBP) ＞20％ of the baseline value, T0] occurred in supine position, SBP, diastolic blood pressure (DBP), mean arterial pressure (MAP), heart rate (HR), cardiac output (CO), cardiac index (CI) and central venous pressure (CVP) were recorded, and ephedrine 0.1 mg/kg (group E) or phenylephrine 1 μg/kg (group P) was injected via the central veins.The parameters mentioned above were recorded within 10 min after administration (T1-T10).Results Both ephedrine and phenylephrine could maintain the parameters of hemodynamics at the normal level.Compared with the baseline values at T0 , SBP, DBP, MAP and HR at T1-T10 and CO and CI at T2-T10 were significantly increased, and no significant change was found in CVP at each time point after administration in group E, and SBP and MAP at T1-T6, DBP at T1-T5, CVP at T2 and T3, and CO and CI at T1-T3 were significantly increased, and HR was decreased at T2 and T3 in group P.Compared with group P, SBP was significantly decreased at T1, and increased at T2-T10, DBP and MAP were decreased at T1, and increased at T3-T10, HR was increased at T1-T10, CO and CI were increased at T2-T10, and CVP was decreased at T1-T3 in group E.Conclusion Compared with phenylephrine, although ephedrine provides no significant effect on hemodynamics clinically, it can increase cardiac output to some extent in the patients undergoing surgery in prone position under general anesthesia.