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Prevention of post-spinal hypotension using crystalloid, colloid and ephedrine with three different combinations: A double blind randomized study.
Adv Biomed Res 2012; 1:36AB

Abstract

BACKGROUND

The benefit of prophylactic combination therapy using crystalloid and colloid preload with ephedrine has not been cleared to prevent maternal hypotension after spinal anesthesia at cesarean delivery. This study evaluated the efficacy of three combinational methods to prevent hypotension following spinal anesthesia.

MATERIALS AND METHODS

In this prospective double blind trial, 150 candidates of elective cesarean delivery under spinal anesthesia were randomly allocated to three treatment groups; 1---Ringer's Lactate (RL) solution (15 ml/kg) plus Hemaxel (7 ml/kg) preload, 2---RL solution (15 ml/kg) preload plus ephedrine (15 mg, IV, bolus), 3---Hemaxel (7 ml/kg) preload plus ephedrine (15 mg, IV, bolus). Maternal hemodynamic changes during 60 min after spinal injection, nausea/vomiting, and neonatal condition were compared among the groups.

RESULTS

The cumulative incidence of hypotension was 44%, 40%, and 46% in groups 1 to 3, respectively. There were not significant differences in supplementary ephedrine requirement among groups which received or among groups which did not receive prophylactic ephedrine. Groups were not different in the incidence of hypertension and nausea or vomiting. There were no significant differences among groups in Apgar scores at 1 or 5 min and umbilical artery PH.

CONCLUSION

Combination of preventive methods decreased the occurrence of hypotension following spinal anesthesia to an acceptable level. Overall, the most effective method was a combination of crystalloid preload with ephedrine.

Authors+Show Affiliations

Department of Anesthesiology, Anesthesiology and Critical Care Research center, Isfahan University of Medical Sciences, Isfahan, Iran.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

23326767

Citation

Jabalameli, Mitra, et al. "Prevention of Post-spinal Hypotension Using Crystalloid, Colloid and Ephedrine With Three Different Combinations: a Double Blind Randomized Study." Advanced Biomedical Research, vol. 1, 2012, p. 36.
Jabalameli M, Soltani HA, Hashemi J, et al. Prevention of post-spinal hypotension using crystalloid, colloid and ephedrine with three different combinations: A double blind randomized study. Adv Biomed Res. 2012;1:36.
Jabalameli, M., Soltani, H. A., Hashemi, J., Behdad, S., & Soleimani, B. (2012). Prevention of post-spinal hypotension using crystalloid, colloid and ephedrine with three different combinations: A double blind randomized study. Advanced Biomedical Research, 1, p. 36. doi:10.4103/2277-9175.100129.
Jabalameli M, et al. Prevention of Post-spinal Hypotension Using Crystalloid, Colloid and Ephedrine With Three Different Combinations: a Double Blind Randomized Study. Adv Biomed Res. 2012;1:36. PubMed PMID: 23326767.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Prevention of post-spinal hypotension using crystalloid, colloid and ephedrine with three different combinations: A double blind randomized study. AU - Jabalameli,Mitra, AU - Soltani,Hassan Ali, AU - Hashemi,Jalal, AU - Behdad,Shekoofe, AU - Soleimani,Bahram, Y1 - 2012/08/28/ PY - 2012/01/22/received PY - 2012/03/09/accepted PY - 2013/1/18/entrez PY - 2013/1/18/pubmed PY - 2013/1/18/medline KW - Cesarean delivery KW - hypotension KW - spinal anesthesia SP - 36 EP - 36 JF - Advanced biomedical research JO - Adv Biomed Res VL - 1 N2 - BACKGROUND: The benefit of prophylactic combination therapy using crystalloid and colloid preload with ephedrine has not been cleared to prevent maternal hypotension after spinal anesthesia at cesarean delivery. This study evaluated the efficacy of three combinational methods to prevent hypotension following spinal anesthesia. MATERIALS AND METHODS: In this prospective double blind trial, 150 candidates of elective cesarean delivery under spinal anesthesia were randomly allocated to three treatment groups; 1---Ringer's Lactate (RL) solution (15 ml/kg) plus Hemaxel (7 ml/kg) preload, 2---RL solution (15 ml/kg) preload plus ephedrine (15 mg, IV, bolus), 3---Hemaxel (7 ml/kg) preload plus ephedrine (15 mg, IV, bolus). Maternal hemodynamic changes during 60 min after spinal injection, nausea/vomiting, and neonatal condition were compared among the groups. RESULTS: The cumulative incidence of hypotension was 44%, 40%, and 46% in groups 1 to 3, respectively. There were not significant differences in supplementary ephedrine requirement among groups which received or among groups which did not receive prophylactic ephedrine. Groups were not different in the incidence of hypertension and nausea or vomiting. There were no significant differences among groups in Apgar scores at 1 or 5 min and umbilical artery PH. CONCLUSION: Combination of preventive methods decreased the occurrence of hypotension following spinal anesthesia to an acceptable level. Overall, the most effective method was a combination of crystalloid preload with ephedrine. SN - 2277-9175 UR - https://www.unboundmedicine.com/medline/citation/23326767/Prevention_of_post_spinal_hypotension_using_crystalloid_colloid_and_ephedrine_with_three_different_combinations:_A_double_blind_randomized_study_ L2 - http://www.advbiores.net/article.asp?issn=2277-9175;year=2012;volume=1;issue=1;spage=36;epage=36;aulast=Jabalameli DB - PRIME DP - Unbound Medicine ER -