REEVALUATION OF IM EPHEDRINE AS PROPHYLAXIS AGAINST HYPOTENSION ASSOCIATED WITH SPINAL-ANESTHESIA FOR CESAREAN-SECTION

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.