Tags

Type your tag names separated by a space and hit enter

Prophylactic intravenous bolus ephedrine for elective Caesarean section under spinal anaesthesia.
Eur J Anaesthesiol. 2002 Jan; 19(1):63-8.EJ

Abstract

BACKGROUND AND OBJECTIVE

To evaluate the efficacy and optimal dose of prophylactic intravenous ephedrine for the prevention of maternal hypotension associated with spinal anaesthesia for Caesarean section.

METHODS

After patients had received an intravenous preload of 0.5 L of lactated Ringer's solution, spinal anaesthesia was administered in the sitting position with hyperbaric bupivacaine 2.5 mL 0.5% combined with 25 microg fentanyl. A total of 68 patients were randomized to receive a simultaneous 2 mL bolus intravenously of either 0.9% saline (Group C, n = 20), ephedrine 6 mg (Group E-6, n = 24), or ephedrine 12 mg (Group E-12, n = 22). Further rescue boluses of ephedrine 6 mg were given if systolic arterial pressure fell to below 90 mmHg, greater than 30% below baseline, or if symptoms suggestive of hypotension were reported.

RESULTS

There was a significantly higher incidence of hypotension in Group C (60% patients) compared to Group E-12 (27%), but not in Group E-6 (50%). The 95% Confidence Interval for the difference in proportions between Groups C and E-12 was 6-60%, P < 0.05. Fewer rescue boluses of ephedrine were required in Group E-12 compared with Group C (1.8 +/- 1.2 vs. 3.3 +/- 2.1, P < 0.05). There were no significant differences in the incidence of maternal nausea or vomiting, or of neonatal acidaemia between groups.

CONCLUSION

A prophylactic bolus of ephedrine 12 mg intravenously given at the time of intrathecal block, plus rescue boluses, leads to a lower incidence of hypotension following spinal anaesthesia for elective Caesarean section compared to intravenous rescue boluses alone.

Authors+Show Affiliations

Department of Anesthesia, Rotunda Hospital, Dublin, Ireland. jloughrey@eircom.netNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

11915786

Citation

Loughrey, J P R., et al. "Prophylactic Intravenous Bolus Ephedrine for Elective Caesarean Section Under Spinal Anaesthesia." European Journal of Anaesthesiology, vol. 19, no. 1, 2002, pp. 63-8.
Loughrey JP, Walsh F, Gardiner J. Prophylactic intravenous bolus ephedrine for elective Caesarean section under spinal anaesthesia. Eur J Anaesthesiol. 2002;19(1):63-8.
Loughrey, J. P., Walsh, F., & Gardiner, J. (2002). Prophylactic intravenous bolus ephedrine for elective Caesarean section under spinal anaesthesia. European Journal of Anaesthesiology, 19(1), 63-8.
Loughrey JP, Walsh F, Gardiner J. Prophylactic Intravenous Bolus Ephedrine for Elective Caesarean Section Under Spinal Anaesthesia. Eur J Anaesthesiol. 2002;19(1):63-8. PubMed PMID: 11915786.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Prophylactic intravenous bolus ephedrine for elective Caesarean section under spinal anaesthesia. AU - Loughrey,J P R, AU - Walsh,F, AU - Gardiner,J, PY - 2002/3/28/pubmed PY - 2002/10/11/medline PY - 2002/3/28/entrez SP - 63 EP - 8 JF - European journal of anaesthesiology JO - Eur J Anaesthesiol VL - 19 IS - 1 N2 - BACKGROUND AND OBJECTIVE: To evaluate the efficacy and optimal dose of prophylactic intravenous ephedrine for the prevention of maternal hypotension associated with spinal anaesthesia for Caesarean section. METHODS: After patients had received an intravenous preload of 0.5 L of lactated Ringer's solution, spinal anaesthesia was administered in the sitting position with hyperbaric bupivacaine 2.5 mL 0.5% combined with 25 microg fentanyl. A total of 68 patients were randomized to receive a simultaneous 2 mL bolus intravenously of either 0.9% saline (Group C, n = 20), ephedrine 6 mg (Group E-6, n = 24), or ephedrine 12 mg (Group E-12, n = 22). Further rescue boluses of ephedrine 6 mg were given if systolic arterial pressure fell to below 90 mmHg, greater than 30% below baseline, or if symptoms suggestive of hypotension were reported. RESULTS: There was a significantly higher incidence of hypotension in Group C (60% patients) compared to Group E-12 (27%), but not in Group E-6 (50%). The 95% Confidence Interval for the difference in proportions between Groups C and E-12 was 6-60%, P < 0.05. Fewer rescue boluses of ephedrine were required in Group E-12 compared with Group C (1.8 +/- 1.2 vs. 3.3 +/- 2.1, P < 0.05). There were no significant differences in the incidence of maternal nausea or vomiting, or of neonatal acidaemia between groups. CONCLUSION: A prophylactic bolus of ephedrine 12 mg intravenously given at the time of intrathecal block, plus rescue boluses, leads to a lower incidence of hypotension following spinal anaesthesia for elective Caesarean section compared to intravenous rescue boluses alone. SN - 0265-0215 UR - https://www.unboundmedicine.com/medline/citation/11915786/Prophylactic_intravenous_bolus_ephedrine_for_elective_Caesarean_section_under_spinal_anaesthesia_ L2 - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&amp;PAGE=linkout&amp;SEARCH=11915786.ui DB - PRIME DP - Unbound Medicine ER -