PREVENTION OF MATERNAL HYPOTENSION BY EPIDURAL ADMINISTRATION OF EPHEDRINE SULFATE DURING LUMBAR EPIDURAL-ANESTHESIA FOR CESAREAN-SECTION

OBJECTIVE: Our purpose was to determine whether epidural administratio n of ephedrine sulfate simultaneously with induction of lumbar epidura l anesthesia for nonemergency cesarean section reduces the incidence o f maternal hypotension. STUDY DESIGN: In a double-blinded, placebo-con trolled trial, 50 normotensive, nonlaboring, American Society of Anest hesiologists' class I or II women with term, uncomplicated, singleton pregnancies were randomly assigned to have normal saline solution or e phedrine sulfate administered epidurally and coincidentally with induc tion of lumbar epidural anesthesia for nonemergency cesarean section. All subjects were prehydrated with 25 ml/kg crystalloid and placed in supine position on a 15-degree, right-sided wedge before and after ind uction. Serial blood pressures were compared with baseline blood press ures, chosen as the average of three preinduction blood pressures. Hyp otension was defined as a decline in systolic blood pressure to less t han or equal to 90 mm Hg or less than or equal to 70% of baseline. Dif ferences between groups were analyzed by Fisher's Exact Test. Signific ance was determined at p < 0.05. RESULTS: The incidence of hypotension in the control group was 24%, which was not significantly different f rom the incidence of 32% in the treated group. CONCLUSION: Prophylacti c epidural administration of ephedrine sulfate does not reduce the inc idence of maternal hypotension after lumbar epidural anesthesia for no nemergency cesarean section.