Comparative incidence of spinal anesthesia-induced hypotension during cesarean delivery between prophylactic intravenous ephedrine group and control group in Somdejprasangkharach XVII hospital
Abstract
Background: Spinal anesthesia is commonly used for cesarean delivery, but spinal hypotension is common complication and can cause maternal or neonatal adverse effect. Vasopressor drug is the most effective for prevention and treatment the hypotension.
Objective: To compare the incidence of spinal anesthesia-induced hypotension between prophylactic intravenous 10-15 mg ephedrine group and control group.
Method: A retrospective comparative study of 1,042 pregnant women who had a single shot spinal anesthesia for cesarean section. The data were collected, between January 2016 and December 2016. Patients were divided in to 2 groups, i.e., control group: patients did not receive prophylactic ephedrine and ephedrine group: patients received prophylactic intravenous ephedrine, 10-15 mg during intrathecal injection. All data were analyzed by numbers, percentage, mean, standard deviation, unpaired t-test and chi-square test.
Results: The incidence of hypotension in the control group was higher than the ephedrine group (68.9% vs 38.7%; p<0.001), and also the incidence of intraoperative and postoperative nausea and vomiting (intraoperative N/V 4.95% vs 0.19%; p<0.001 and postoperative N/V 22.57% vs 12.3%; p< 0.001). But vasopressors were used in control group less amount than ephedrine group (ephedrine, 8.37±8.82 mg & 10.68±3.23 mg; p<0.001, norepinephrine, 13.13±13.74 mcg & 19.99±18.08 mcg; p<0.001). There was no difference in neonatal outcome between the two groups (Apgar score at 1,5,10 min were 8.92±0.53, 9.90±0.57, 9.94±0.52 in control group and 8.91±0.53, 9.91±0.54, 9.95±0.48 in ephedrine group; p= 0.898, 0.783, 0.718 respectively). There was no reactive hypertension in both groups.
Conclusion: Prophylactic intravenous ephedrine could effectively prevent spinal anesthesia-induced hypotension during cesarean delivery and also decreased incidence of nausea and vomiting at both intraoperative and postoperative period. This research evidence will be used for CPG development in Somdejprasangkharach XVII hospital which can be applied to achieve the maximal benefits on the patients.
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ลิขสิทธิ์บทความเป็นของผู้เขียนบทความ แต่หากผลงานของท่านได้รับการพิจารณาตีพิมพ์ลงวารสารแพทย์เขต 4-5 จะคงไว้ซึ่งสิทธิ์ในการตีพิมพ์ครั้งแรกด้วยเหตุที่บทความจะปรากฎในวารสารที่เข้าถึงได้ จึงอนุญาตให้นำบทความในวารสารไปใช้ประโยชน์ได้ในเชิงวิชาการโดยจำเป็นต้องมีการอ้างอิงถึงชื่อวารสารอย่างถูกต้อง แต่ไม่อนุญาตให้นำไปใช้ในเชิงพาณิชย์
