Ephedrine Infusion Instead of Crystalloid Preloading to Prevent Spinal Hypotension in Lower Abdominal Surgeries
Journal Title: Journal of Medical Science And clinical Research - Year 2017, Vol 5, Issue 12
Abstract
Spinal anesthesia is one of the most popular techniques for lower limb and lower abdominal procedures. Various prophylactic methods like prehydration, head up position and vasopressors have been used to minimize hypotension associated with it. In our study, we used prophylactic Ephedrine infusion to prevent hypotension, in spinal anaesthesia. 80 ASA I and II patients aged 20 to 60 years were randomly allocated into two equal groups. Group 1 received prophylactic intravenous infusion of Ephedrine at the rate of 5mg/min for the first two minutes followed by 1mg/min for the next 18 minutes following spinal block. Group 2 received crystalloid preloading at 15 ml/kg over 15 to 20 minutes before spinal block. Patients in both the groups were given maintenance infusion of crystalloid at the rate of 5ml/kg for 20 minutes after spinal block and according to requirement thereafter. Hypotension was taken as more than 20% fall in Systolic BP from baseline. The occurrence of any side effects was also monitored. Incidence of hypotension was significantly higher in the control group (82.2%) vs Ephedrine group (22.5%); p <0.001. Additional Ephedrine boluses needed to treat hypotension was significantly lower in Ephedrine group (p < 0.001). No side effects were noted in 67.5% patients in Ephedrine group compared to 62.5% for control group. There was 7.5% incidence of reactive hypertension(>140/90 mm hg) and 20% had tachycardia (>100/ min) in the Ephedrine group. Administration of prophylactic Ephedrine infusion is a suitable alternative to preloading with crystalloids. Incidence of hypotension is lower and BP maintains a more stable trend. But it is safe to avoid it in patients with preexisting tachycardia or hypertension.
Authors and Affiliations
Dr Sheeja Krishnan
Keywords
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