Is ephedrine infusion more effective at preventing hypotension than traditional prehydration during spinal anaesthesia for caesarean section in African parturients?

Desalu, I; Kushimo, O T

doi:10.1016/j.ijoa.2005.05.002

Cited by 31 publications

(23 citation statements)

References 20 publications

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“…Phenylephrine can be used for the prevention and treatment of maternal hypotension (13-15) but a reduction of fetal oxygenation due to uterine vasoconstriction has been observed in animals (16). It may cause maternal bradycardia (14, 17).…”

Section: Discussionmentioning

confidence: 99%

The Effects of Intravenous Ephedrine During Spinal Anesthesia for Cesarean Delivery: A Randomized Controlled Trial

et al. 2009

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We designed a randomized, double-blinded study to determine the efficacy and safety of 0.5 mg/kg intravenous ephedrine for the prevention of hypotension during spinal anesthesia for cesarean delivery. Patients were randomly allocated into two groups: ephedrine group (n=21) and control group (n=21). Intravenous preload of 15 mL/kg lactated Ringer's solution was given. Shortly after the spinal injection, ephedrine 0.5 mg/kg or saline was injected intravenous for 60 sec. The mean of highest and lowest heart rate in the ephedrine group was higher than those of control group (P<0.05). There were significant lower incidences of hypotension and nausea and vomiting in the ephedrine group compared with the control group (8 [38.1%] vs. 18 [85.7%]); (4 [19%] vs. 12 [57.1%], respectively) (P<0.05). The first rescue ephedrine time in the ephedrine group was significantly longer (14.9±7.1 min vs. 7.9±5.4 min) than that of the control group (P<0.05). Neonatal outcome were similar between the study groups. These findings suggest, the prophylactic bolus dose of 0.5 mg/kg intravenous ephedrine given at the time of intrathecal block after a crystalloid fluid preload, plus rescue boluses reduce the incidence of hypotension.

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Section: Discussionmentioning

confidence: 99%

The Effects of Intravenous Ephedrine During Spinal Anesthesia for Cesarean Delivery: A Randomized Controlled Trial

et al. 2009

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“…[15][16][17] Genel anestezide kullanılan ilaçların plasentayı geçerek fetüsü etkilemesi sonucunda yenidoğanın Apgar skorları düşük bulunabilir. Buna karşın rejyonal anestezinin neden olduğu maternal hipotansiyon ise uteroplasental kan akımını etkileyerek fetal asidoz, asfiksi ve düşük Apgar skorlarına yol açabilir.…”

Section: Discussionunclassified

“…da, hipotansiyon süresi uzun olan annelerin bebeklerinde 1. dk Apgar skorlarını daha düşük (Apgar skoru<7) saptamış-lardır. 16 Shusee ve ark.nın yapmış oldukları çalış-mada ise Apgar skorları ve umbilikal arter kan gazı analizleri gruplar (spinal ve epidural) arasında benzer saptanmıştır (p>0,05). Araştırmacılar bunu, hipotansiyonun kısa süreli olması nedeni ile uteroplasental kan akımının hiçbir grupta bozulmamış olabileceğine bağlamışlardır.…”

Section: Discussionunclassified

The Effects of Anesthetic Techniques on Mother and Newborn for Cesarean Inparturients with Preeclampsia: Retrospective Study

Sever¹,

Günüşen²,

Sargın³

et al. 2015

Turkiye Klinikleri J Anest Reanim

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Ö ÖZ ZE ET T A Am ma aç ç: : Bu çalışmada 2005-2010 yılları arasında preeklampsi tanısı ile sezaryen (S/C) uygulanan gebelerdeki anestezi yöntemlerinin, anne ve yenidoğan üzerine olan etkilerinin geriye dönük olarak incelenmesi amaçlanmıştır. G Ge er re eç ç v ve e Y Yö ön nt te em ml le er r: : Hastane medikal sistemine kayıtlı dosyaların taranması sonucu preeklampsi tanısı alan ve S/C uygulanan 211 hastanın demografik ve gebelikle ilgili özellikleri, yandaş hastalıklar, ilaç tedavileri, anestezi yöntemleri, hemodinamik veriler, komplikasyonlar ve yenidoğana ait özellikler kaydedildi. B Bu ul lg gu ul la ar r: : Hastaların %75,8'inin acil, %24,2'sinin ise elektif olarak S/C'e alındığı saptandı. Hastaların %23 (n=49)'üne genel anestezi, %69 (n=145)'una spinal anestezi, %8 (n=17)'ine ise epidural anestezi uygulandığı görüldü. Acil vakalarda genel ve spinal anestezi arasında anlamlı fark yoktu. İstatistiksel açıdan ise sadece epidural anestezi uygulanan grupla diğer iki grup arasında acil ve elektif operasyon açısından anlamlı fark saptandı (p=0,021). Yenidoğan 1. dk Apgar skorunun, genel anestezi uygulanan gebelerin bebeklerinde spinal ve epidural anestezi uygulanan gebelerin bebeklerinden daha düşük olduğu saptandı (p=0,003). Yenidoğanların 5. dk Apgar skorları gruplar arasında benzer, 1. dk Apgar skorları ise genel anestezi grubunda daha düşüktü. Acil vakalarda yenidoğan 1 ve 5. dk. Apgar skorlarının daha düşük olduğu bulundu (p<0,0001). Annenin yoğun bakım ihtiyacı ise hiçbir grupta olmadı. S So on nu uç ç: : Preeklamptik gebelerde anestezik yönetim, anne ve yenidoğan sağlığı açısından peripartum dönemde önemli bir rol oynamaktadır. Araştırmamız, yenidoğan üze-rine etkileri açısından rejyonal anestezinin daha iyi bir yöntem olabileceğini, uygulanan anestezi yönteminin anne üzerinde ise etkisinin olmadığını ortaya koymaktadır.A An na ah h t ta ar r K Ke e l li i m me e l

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“…While Adigun et al [8] reported an incidence of 24.2% in their study using bolus phenylephrine and ephedrine during spinal anaesthesia for Caesarean section, Desalu and Kushimo [9] reported an incidence of 40% in patients who received ephedrine infusion.…”

Section: Discussionmentioning

confidence: 99%

“…One study [11] reported an incidence of 4.25% for nausea and vomiting while another [9] reported incidences of 41.7% and nil respectively for nausea and vomiting in parturients who received ephedrine infusion during spinal anaesthesia for Caesarean section. One patient in this study had extensive adhesiolysis from previous Caesarean deliveries but did not develop hypotension.…”

Section: Phenylephrine Ephedrinementioning

confidence: 99%

Prophylactic Infusions of Phenylephrine and Ephedrine during Combined Spinal Epidural Anaesthesia for Caesarean Section: A Comparative Study

S¹

2013

J Anesth Clin Res

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Background: Hypotension is the most common adverse effect in parturients after spinal anaesthesia for Caesarean section. Despite various pharmacological and non-pharmacological methods used in its prevention and treatment, vasopressors have become very important in the management of this form of hypotension.Objective: This study was aimed at comparing the efficacy and safety of prophylactic intravenous infusions of phenylephrine and ephedrine at preventing maternal hypotension during Combined Spinal Epidural anaesthesia (CSE) for Caesarean section.Methods: Sixty ASA I and II patients scheduled for elective Caesarean section, were randomly allocated into two groups. Patients in Group I received Phenylephrine 80 μg/min while patients in Group II received Ephedrine 1 mg/min immediately after the subarachnoid 10 mg plain bupivacaine injection while the epidural catheter was being inserted and secured. All the patients received a crystalloid preload of 1 litre of 0.9% normal saline prior to the induction of CSE. Results:The overall incidence of hypotension was 8.5% (6.7% in the phenylephrine group and 10.3% in the ephedrine groups). The lowest systolic (105.8 ± 9.2 mmHg) and diastolic arterial pressures (60.9 ± 8.9 mmHg) occurred in the ephedrine group while the lowest heart rates occurred in the phenylephrine group. The mean umbilical artery pH was 7.3 while Apgar scores at 1 st and 5 th min were essentially the same in the two groups. Conclusion:Prophylactic intravenous infusions of phenylephrine and ephedrine are safe and effective at reducing the incidence and severity of hypotension during combined spinal epidural anaesthesia for elective Caesarean section with no associated neonatal acidosis.

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Is ephedrine infusion more effective at preventing hypotension than traditional prehydration during spinal anaesthesia for caesarean section in African parturients?

Cited by 31 publications

References 20 publications

The Effects of Intravenous Ephedrine During Spinal Anesthesia for Cesarean Delivery: A Randomized Controlled Trial

The Effects of Intravenous Ephedrine During Spinal Anesthesia for Cesarean Delivery: A Randomized Controlled Trial

The Effects of Anesthetic Techniques on Mother and Newborn for Cesarean Inparturients with Preeclampsia: Retrospective Study

Prophylactic Infusions of Phenylephrine and Ephedrine during Combined Spinal Epidural Anaesthesia for Caesarean Section: A Comparative Study

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