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Comparison of the Hemodynamic Effects of Pretreatment with Crys-talloids versus Crystalloids plus Ephedrine during Spinal Anesthesia for Caesarean Section.


1 Associate Professor, Department of Obstetrics and Gynecology, Zahedan University of Medical Sciences, Zahedan, Iran.
2 Associate Professor, Department of Anatomy, School of Medicine,Shahid Beheshti University of Medical Sciences, Tehran, Iran.
*Corresponding Author: M Khooshideh, Department of Obstetrics and Gynecology, School of Medicine, Zahedan University of Medical Sciences, Kha Ali Ebne Abitaleb Hospital, Zahedan, Iran, Telephone: +98 (915) 141-9158, E-mail: [email protected].
Shiraz E-Medical Journal. 2009 April; 10(2): 59-65.
Article Type: Research Article; Received: Jul 31, 2008; Accepted: Feb 11, 2009; epub: Apr 1, 2009; ppub: Apr 2009

Abstract


Background:: Prevention of hypotension during spinal anesthesia for cesarean section avoids maternal and fetal side effects. The aim of this study was to compare the effects of the com-bination of ephedrine crystalloid and prehydration with crystalloid alone on maternal blood pressure and neonatal outcome during cesarean section under spinal anesthesia.

Method:: We enrolled 72 full term women weighing between 50 and 75 Kg, classified as ASA I, scheduled for elective caesarean section under spinal anesthesia. Participants were ran-domly allocated to either the ephedrine or crystalloid group. After arrival in the operating room and intravenous (IV) access, 10 ml/Kg of ringer solution was infused 10-15 minutes before the initiation of the spinal block, but in the ephedrine group, an additional 10mg of ephedrine was added to the solution for infusion. In the crystalloid group, a placebo was added to the solution.

Results:: Hypotension occurred in 55.6% of patients in the crystalloid group and in 25% of patients in the ephedrine group. The difference between the two groups was found to be statistically significant (P = 0.008), however, there was no significant difference in mean systolic blood pressure between the two groups (105.61± 7.13 in crystalloid group vs. 107.89 ± 9.84 in ephedrine group). Apgar scores in newborns were above 8 in both groups.

Conclusion:: Prophylactic ephedrine given by infusion in combination with crystalloid was more effective than crystalloid prehydration in the prevention of hypotension during spinal anesthesia for elective caesarean section.

Keywords: Spinal anesthesia; Ephedrine; Crystalloid; Hypotension