Sk. Kafle et al., PROPHYLACTIC ORAL EPHEDRINE REDUCES THE INCIDENCE OF HYPOTENSION AFTER SUBARACHNOID BLOCK, Canadian journal of anaesthesia, 41(11), 1994, pp. 1091-1093
The purpose of this study was to demonstrate the efficacy of oral ephe
drine in preventing hypotension following subarachnoid block. Two hund
red women, ASA physical status I or II, undergoing lower abdominal sur
gery were randomly divided into two groups (n = 100 each). All patient
s were given routine oral premedication consisting of diazepam 10 mg a
nd ranitidine 150 mg at bed time and at 90 min before surgery. In addi
tion, Group I patients received ephedrine 30 mg, orally, 30 min before
subarachnoid block was administered. Group II received only routine p
remedication. After starting an iv line and preloading with 10 ml . kg
(-1) crystalloid, patients were given 0.5% heavy bupivacaine 3.2 to 3.
6 ml, depending on body weight, intrathecally. Patients with decreases
in blood pressure of 20% were given ephedrine iv, in increments, in a
ddition to crystalloids. Despite a similar level of block (T-3-T-4) an
d iv fluids, the total dose of ephedrine supplement in Group I was 4.3
+/- 4.8 mg compared with 11.6 +/- 9.4 mg in Group II (P < 0.01). Also
, 55 patients in Group I required intraoperative inotrope supplement c
ompared with 83 in Group II (P < 0.01). We conclude that oral ephedrin
e premedication is a simple and effective way of reducing the incidenc
e of hypotension in patients undergoing lower abdominal surgery under
subarachnoid block.