1.The Effects of Intravenous Ephedrine During Spinal Anesthesia for Cesarean Delivery: A Randomized Controlled Trial.
Iclal Ozdemir KOL ; Kenan KAYGUSUZ ; Sinan GURSOY ; Ali CETIN ; Zeki KAHRAMANOGLU ; Fikret OZKAN ; Caner MIMAROGLU
Journal of Korean Medical Science 2009;24(5):883-888
We designed a randomized, double-blinded study to determine the efficacy and safety of 0.5 mg/kg intravenous ephedrine for the prevention of hypotension during spinal anesthesia for cesarean delivery. Patients were randomly allocated into two groups: ephedrine group (n=21) and control group (n=21). Intravenous preload of 15 mL/kg lactated Ringer's solution was given. Shortly after the spinal injection, ephedrine 0.5 mg/kg or saline was injected intravenous for 60 sec. The mean of highest and lowest heart rate in the ephedrine group was higher than those of control group (P<0.05). There were significant lower incidences of hypotension and nausea and vomiting in the ephedrine group compared with the control group (8 [38.1%] vs. 18 [85.7%]); (4 [19%] vs. 12 [57.1%], respectively) (P<0.05). The first rescue ephedrine time in the ephedrine group was significantly longer (14.9+/-7.1 min vs. 7.9+/-5.4 min) than that of the control group (P<0.05). Neonatal outcome were similar between the study groups. These findings suggest, the prophylactic bolus dose of 0.5 mg/kg intravenous ephedrine given at the time of intrathecal block after a crystalloid fluid preload, plus rescue boluses reduce the incidence of hypotension.
Adult
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*Anesthesia, Spinal/adverse effects
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Blood Pressure/drug effects
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*Cesarean Section
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Ephedrine/administration & dosage/*therapeutic use
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Female
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Heart Rate/drug effects
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Humans
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Hypotension/chemically induced/prevention & control
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Injections, Intravenous
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Postoperative Nausea and Vomiting/prevention & control
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Pregnancy
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Vasoconstrictor Agents/administration & dosage/*therapeutic use