Aa. Webb et Ea. Shipton, REEVALUATION OF IM EPHEDRINE AS PROPHYLAXIS AGAINST HYPOTENSION ASSOCIATED WITH SPINAL-ANESTHESIA FOR CESAREAN-SECTION, Canadian journal of anaesthesia, 45(4), 1998, pp. 367-369
Purpose: To assess the safety and efficacy of 37.5 mg ephedrine im in
preventing hypotension associated with spinal anaesthesia for Caesarea
n section. Methods: In a double-blind randomised controlled study, 40
patients (20 in each group) were given either 37.5 mg ephedrine or pla
cebo im. The following parameters were recorded: (i) blood pressure; (
ii) heart rate; (iii) ephedrine iv supplementation; (iv) umbilical ven
ous blood gases and neonatal Apgar scores. Results: The incidence of h
ypertension in the study group was 30% compared with 20% for the contr
ol group (P:NS). There was no difference in mean highest blood pressur
e or mean highest heart rate between the groups. The incidence of hypo
tension was lower but not significantly lower in the study group (50%)
than in the control group (80%) (P:NS). However, the incidence of del
ayed hypotension was only 10% in the study group patients compared wit
h;50% in the control group patients (P < 0.05). Conclusion: Giving 37.
5 mg ephedrine im prior to spinal anaesthesia was not associated with
reactive hypertension or tachycardia. Intramuscular ephedrine provided
more sustained cardiovascular support than intravenous ephedrine.