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Prophylactic effects of systemic oral ephedrine in spinal anesthesia-induced hypotension during transurethral prostatectomy.
Scand J Urol Nephrol 2003; 37(2):145-50SJ

Abstract

OBJECTIVE

We investigated the prophylactic effects of systemic oral ephedrine in spinal anesthesia-induced hypotension during transurethral prostatectomy.

MATERIAL AND METHODS

Sixty American Society of Anesthesiologists Grade II and III patients scheduled for spinal anesthesia were randomized into one of two groups. Patients in Group I (n = 30) received oral ephedrine 50 mg in addition to premedication whilst those in Group II (n = 30) received only premedication 30 min before spinal anesthesia. Pre-infusion values were measured in order to obtain baseline readings after oral ephedrine administration in Group I and after premedication in Group II. Systolic arterial pressure (SAP) and heart rate (HR) were recorded before and after infusion, during and 5 min after spinal anesthesia and intraoperatively. Hypotension was defined as SAP <100 mmHg and <20% of baseline value. Hypotension was treated with 3 mg ephedrine and bradycardia was corrected with atropine 0.5 mg, given as an i.v. bolus.

RESULTS

SAP values were significantly lower in Group II during the spinal anesthesia, post-spinal and intraoperative periods (p < 0.0001). Fifteen patients received ephedrine in Group II and seven in Group I. Supplemental ephedrine was used at doses of 3.42 +/- 0.97 mg in Group I and 8.86 +/- 1.24 mg in Group II. The incidence of hypotension was halved in Group I compared to Group II (23.33% vs 50%, p = 0.003). Six patients received atropine in Group II because of severe bradycardia. Mean HR values were lower in Group II than Group I during the spinal anesthesia, post-spinal and intraoperative periods.

CONCLUSIONS

We conclude that a prophylactic oral dose of ephedrine 50 mg is effective for minimizing and managing spinal anesthesia-induced hypotension during transurethral prostatectomy.

Authors+Show Affiliations

Department of Anesthesiology and Reanimation, School of Medicine, Suleyman Demirel University, Balikci Sokak, Zehra Dilmen Apt. No:1/12, TR-32040 Isparta, Turkey. eroglufusun@hotmail.comNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

12745724

Citation

Eroglu, Fusun, et al. "Prophylactic Effects of Systemic Oral Ephedrine in Spinal Anesthesia-induced Hypotension During Transurethral Prostatectomy." Scandinavian Journal of Urology and Nephrology, vol. 37, no. 2, 2003, pp. 145-50.
Eroglu F, Yavuz L, Ceylan BG, et al. Prophylactic effects of systemic oral ephedrine in spinal anesthesia-induced hypotension during transurethral prostatectomy. Scand J Urol Nephrol. 2003;37(2):145-50.
Eroglu, F., Yavuz, L., Ceylan, B. G., Sevin, G., & Soyupek, S. (2003). Prophylactic effects of systemic oral ephedrine in spinal anesthesia-induced hypotension during transurethral prostatectomy. Scandinavian Journal of Urology and Nephrology, 37(2), pp. 145-50.
Eroglu F, et al. Prophylactic Effects of Systemic Oral Ephedrine in Spinal Anesthesia-induced Hypotension During Transurethral Prostatectomy. Scand J Urol Nephrol. 2003;37(2):145-50. PubMed PMID: 12745724.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Prophylactic effects of systemic oral ephedrine in spinal anesthesia-induced hypotension during transurethral prostatectomy. AU - Eroglu,Fusun, AU - Yavuz,Lutfi, AU - Ceylan,Berit Gokce, AU - Sevin,Guven, AU - Soyupek,Sedat, PY - 2003/5/15/pubmed PY - 2004/3/17/medline PY - 2003/5/15/entrez SP - 145 EP - 50 JF - Scandinavian journal of urology and nephrology JO - Scand. J. Urol. Nephrol. VL - 37 IS - 2 N2 - OBJECTIVE: We investigated the prophylactic effects of systemic oral ephedrine in spinal anesthesia-induced hypotension during transurethral prostatectomy. MATERIAL AND METHODS: Sixty American Society of Anesthesiologists Grade II and III patients scheduled for spinal anesthesia were randomized into one of two groups. Patients in Group I (n = 30) received oral ephedrine 50 mg in addition to premedication whilst those in Group II (n = 30) received only premedication 30 min before spinal anesthesia. Pre-infusion values were measured in order to obtain baseline readings after oral ephedrine administration in Group I and after premedication in Group II. Systolic arterial pressure (SAP) and heart rate (HR) were recorded before and after infusion, during and 5 min after spinal anesthesia and intraoperatively. Hypotension was defined as SAP <100 mmHg and <20% of baseline value. Hypotension was treated with 3 mg ephedrine and bradycardia was corrected with atropine 0.5 mg, given as an i.v. bolus. RESULTS: SAP values were significantly lower in Group II during the spinal anesthesia, post-spinal and intraoperative periods (p < 0.0001). Fifteen patients received ephedrine in Group II and seven in Group I. Supplemental ephedrine was used at doses of 3.42 +/- 0.97 mg in Group I and 8.86 +/- 1.24 mg in Group II. The incidence of hypotension was halved in Group I compared to Group II (23.33% vs 50%, p = 0.003). Six patients received atropine in Group II because of severe bradycardia. Mean HR values were lower in Group II than Group I during the spinal anesthesia, post-spinal and intraoperative periods. CONCLUSIONS: We conclude that a prophylactic oral dose of ephedrine 50 mg is effective for minimizing and managing spinal anesthesia-induced hypotension during transurethral prostatectomy. SN - 0036-5599 UR - https://www.unboundmedicine.com/medline/citation/12745724/Prophylactic_effects_of_systemic_oral_ephedrine_in_spinal_anesthesia_induced_hypotension_during_transurethral_prostatectomy_ L2 - http://www.tandfonline.com/doi/full/10.1080/00365590310008893 DB - PRIME DP - Unbound Medicine ER -