Comparative Study of Preloading with Ringer Lactate and Intravenous Ephedrine for Prevention of Hypotention during Propofol Induction in Patient Undergoing Elective Abdominal Surgery under General Anaesthesia.
Journal Title: International Journal of Medical Science and Innovative Research (IJMSIR) - Year 2019, Vol 4, Issue 5
Abstract
Background: Propofol is ideal induction agent for short and ambulatory surgical procedures requiring general anaesthesia, as recovery is rapid with fewer unwanted side effects, such as drowsiness on recovery, disorientation and nausea, when compared with other agents such as Thiopentone. In this study compared the efficacy of preloading with Ringer Lactate (crystalloid) with IV Ephedrine Sulfate (Vasoconstrictor) in prevention of hypotension during Propofol induction. Method: Prospective, randomised observational study including 90 patients of ASA physical status I and II, 20 to 50 yrs age of both gender, scheduled for elective abdominal surgery, were assigned by pre randomized, sealed envelopes into three study groups and receive the following: Group C(n=30) :inj. Propofol (2mg/kg),Group E(n=30):inj. Propofol (2mg/kg) and inj.Ephedrine 70 ug/kg, Group RL(n=30): inj.Propofol (2mg/kg) and inj. Ringer Lactate(10ml/kg). Heart rate, Blood pressure (SBP,DBP,MAP) were recorded before induction (baseline) and immediate, 01min.,03min., 05min.post induction. Results: Preoperative Ephedrine Sulphate failed to prevent the delayed post induction hypotension and led to excessive increase in the heart rate that may not be tolerated in the high risk patients. On the other hand, preoperative volume loading with 10ml/kg Ringer Lactate over 10-15 min successfully antagonised Propofol induced hypotension without increments in the heart rate. Therefore, volume loading with Ringer's Lactate provides more haemodynamic stability than the pre-induction administration of Ephedrine Sulphate. Conclusion: Preoperative Ephedrine Sulphate failed to prevent the delayed post induction hypotension and led to excessive increase in the heart rate that may not be tolerated in the high risk patients.
Authors and Affiliations
Sunil Agarwal
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