The effect of oral etilefrine premedication on the incidence of hypotension during spinal anaesthesia

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.