PROPHYLACTIC EPHEDRINE ATTENUATES THE HEMODYNAMIC-RESPONSE TO PROPOFOL IN ELDERLY FEMALE-PATIENTS

In this study, we compared the effect of prophylactic administration o f ephedrine against the hypotensive effect of propofol in elderly fema le patients scheduled for minor gynecological procedures. Ninety patie nts aged 60 yr or older were randomly allocated to one of three groups of 30 patients each to receive either normal saline, ephedrine 0.1 mg /kg, or ephedrine 0.2 mg/kg IV 1 min before the induction of anesthesi a. Anesthesia was induced and maintained with propofol and fentanyl. H emodynamic variables were measured before and 2, 5, 10, 15, 30, and 60 min after induction. The decrease in blood pressure and heart rate (H R) was significantly less in each of the ephedrine groups (P < 0.001). Furthermore, the decrease was less in the large-dose group compared w ith the small-dose group (P < 0.05). Twelve patients in the control gr oup experienced a decrease in systolic blood pressure to <80 mm Hg, co mpared with only one patient in the ephedrine groups (P < 0.001). In c onclusion, the prophylactic injection of ephedrine significantly atten uated, but did not completely abolish, the decrease in blood pressure associated with induction of anesthesia with fentanyl and propofol. Ep hedrine 0.2 mg/kg was slightly more effective than ephedrine 0.1 mg/kg . Implications: The prophylactic effect of ephedrine to counteract the hypotensive effect of propofol induction of anesthesia was investigat ed in three groups of elderly female patients given 0.1 or 0.2 mg of e phedrine or placebo before induction. Both ephedrine doses markedly at tenuated, but neither of them abolished, the decrease in blood pressur e.