COMPARISON EFFECTIVENESS OF PROPHYLACTIC INTRAVENOUS EPHEDRINE WITH PRELOADING VERSUS PRELOADING ALONE IN PREVENTION OF HYPOTENSION DURING ELECTIVE CAESAREAN SECTION UNDER SPINAL ANESTHESIA
Keywords:
Key words : Spinal anesthesia , Hypotension , Caesarean section , EphedrineAbstract
Introduction : The prevention and treatment of maternal hypotension associated with spinal anesthesia for C-section remains a problem. Prophylactic ephedrine alone is at least as good as fluid preload alone in combating the hypotension associated with spinal anesthesia for caesarean section but there is no consensus about the dose of prophylactic intravenous ephedrine for prevention of spinal induced maternal hypotension.
Objectives: To compare incidence of hypotension and the other side effects between intravenous bolus of prophylactic ephedrine with preloading versus preloading alone
Methods : Randomized controlled trial, double blind study .Eighty-six parturients were recruited who scheduled to receive spinal anesthesia for elective cesarean section.The parturients were randomized into 2 groups (Control group and Ephedrine group).Control group received only preloading fluid 15 ml per kilogram. Ephedrine group received preloading fluid with prophylactic intravenous ephedrine 15 mg within 1 min after spinal anesthesia.
Results: There was a significantly lower incidence of hypotension in ephedrine group compare to control group[13( 30.2% )vs 24( 55.8%) , p=0.02)].Reactive hypertension was found only in ephedrine group[9, (20.9%), p=0.002]
Conclusion: A prophylactic bolus of ephedrine 15mg intravenously given within 1 minute of spinal anesthesia with preloading leads to a lower incidence of hypotension following spinal anesthesia for elective caesarean section compared to preloading alone.
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