A. Bouaggad et al., The effect of oral etilefrine premedication on the incidence of hypotension during spinal anaesthesia, EUR J ANAES, 17(3), 2000, pp. 177-181
This study was designed to determine the efficacy of oral etilefrine in pre
venting hypotension induced by spinal anaesthesia. Forty patients, ASA grad
e I or II, aged 23-60 years, scheduled for orthopaedic surgery involving th
e lower extremity under spinal anaesthesia were studied. The patients were
randomly allocated to one of two groups; the etilefrine group (n = 20) rece
ived oral etilefrine 15 mg (30 drops), 60 min before the subarachnoid block
, and the control group (n = 20) received no etilefrine. Patients were give
n 0.5% isobaric bupivacaine intrathecally. Hypotension was defined as a 30%
decrease from base-line for systolic arterial pressure and mean arterial p
ressure or systolic value < 90 mmHg, and was treated with intravenous bolus
es of etilefrine 2 mg. The overall incidence of spinal anaesthesia induced
hypotension was 25%, ranging from 20% in the etilefrine group to 30% in the
control group. The fall in systolic arterial pressure and mean arterial pr
essure was significantly greater in the control group than in the etilefrin
e group (P < 0.05). The patients in the etilefrine group received less etil
efrine supplement than those in control group and no subject in the etilefr
ine group required repeat etilefrine doses, while in the control group five
patients received multiple etilefrine doses (P < 0.05). The mean heart rat
e remained fairly stable throughout the study periods. We conclude that ora
l etilefrine, given 60 min before surgery, reduces the fall in blood pressu
re during spinal anaesthesia.