Prophylactic oral ephedrine reduces the incidence of hypotension after subarachnoid block

Kafle, S. K.; Malla, Sadiq; Lekhak, B. D.

doi:10.1007/bf03015660

Cited by 9 publications

(6 citation statements)

References 6 publications

(1 reference statement)

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“…Similarly, Sternlo et al [7] had investigated the efficacy of IM ephedrine in elderly patients undergoing hip arthroplasty under spinal anesthesia with plain bupivacaine and concluded that ephedrine administered in the paravertebral muscles immediately after spinal anesthesia was a simple and effective means of reducing the incidence of hypotensive episodes in the elderly patient. Katie et al [8] investigated two hundred women, ASA physical status I or II undergoing lower abdominal surgery concluded that oral ephedrine premedication (30 minutes before spinal anesthesia) was a simple and effective way of reducing the incidence of hypotension compared to control group (p<0.01). Kohki et al…”

Section: Discussionmentioning

confidence: 99%

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Prevention of Spinal Anesthesia Induced Hypotension in Elderly: Comparison of Prophylactic Atropine with Ephedrine

Shrestha¹,

Amatya²

2015

J Anesth Clin Res

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Background: Spinal anesthesia induced hypotension is more common and hazardous in elderly, as they have decreased physiological reserve and compromised blood supply to various vital organs. Reversal of the blunted reflexes of tachycardia following hypotension in elderly with atropine or ephedrine may help in prevention of hypotension.Methodology: Present study is a prospective, randomized, double blind, controlled trial where sixty ASAPS I-II patients undergoing urological surgeries were assigned to receive either IV normal saline (placebo) or IV atropine 0.6 mg or IV ephedrine 12 mg one minute after induction of spinal anesthesia. Heart rate (HR), mean arterial pressure (MAP), requirement mephentermine and phenylephrine and side effects profile were studied were studied. Hemodynamic parameters were compared with baseline in each and among the groups. Results:The patients were comparable with demographic data, baseline hemodynamic parameters and duration of surgery. Compared to baseline, trend of mean HR and MAP significantly dropped in placebo in most of the times (p group (5%)]. Conclusion:Administration of intravenous atropine 0.6 mg or IV ephedrine (12 mg) one min after induction of spinal anesthesia in elderly patient is safe and effective in the prevention of spinal anesthesia induced hypotension and bradycardia, requirement of vasopressors decreased without clinically significant side effects.

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Section: Discussionmentioning

confidence: 99%

“…So, the prophylactic use of atropine helps in preventing the blunted reflexes thus increasing heart rate and cardiac output, which finally increases blood pressure. Various studies also showed that ephedrine too improve hemodynamic parameter when used preoperatively in spinal aesthesia [6][7][8][9].…”

Section: Introductionmentioning

confidence: 99%

Prevention of Spinal Anesthesia Induced Hypotension in Elderly: Comparison of Prophylactic Atropine with Ephedrine

Shrestha¹,

Amatya²

2015

J Anesth Clin Res

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“…The use of 50mg IM ephedrine was found to be associated with higher incidence of hypertension as shown in the study by Rout CC et al 11 and Rolbin SH et al 12 whereas the use of oral ephedrine either 30mg or 50mg was found to be associated with the no incidence of hypertension in study done by Kafle et al 2 and Eroglu et al 3 .…”

Section: Discussionmentioning

confidence: 87%

The efficacy of oral ephedrine in prevention of hypotension following spinal anesthesia in LSCS

2015

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Background: Systemic hypotension is seen frequently after spinal anesthesia in obstetric population and if untreated can lead to maternal and fetal complications. Ephedrine, via various routes, has been used both as prophylaxis and treatment of this hypotension. Oral ephedrine has been found to be effective in prevention of hypotension in non obstetric patients after neural block. Objective: To study the efficacy of oral ephedrine in prevention of hypotension following spinal anesthesia in LSCS and to assess the neonatal outcome. Methods: It was a randomized, controlled double blinded study involving 100 parturients undergoing LSCS. Total duration of study was two years. A preformed structured proforma was used to record the data incidence of hypotension and neonatatal APGAR score were the main outcome variables. This study was carried out in 100 ASA physical status I and II patients admitted for emergency and elective LSCS. Fifty patients received placebo and 50 patients received prophylactic ephedrine orally, before spinal anesthesia. The two groups were compared in respect of their incidences of hypotension and maintenance of SBP and neonatal outcome. Results: The incidence of hypotension was much higher in patients who received placebo than who received prophylactic ephedrine orally (19 vs. 6). APGAR score for assessment of neonatal wellbeing was similar in two groups. Conclusions: The prophylactic oral ephedrine 30 mg, given 30-45 minutes before LSCS, is a simple and effective measure to prevent hypotension following spinal anesthesia and it does not have any adverse effect on neonatal outcome.

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“…Recently, Kafle and colleagues[14] demonstrated that oral ephedrine, given 30–45 min before surgery, is a simple and effective method of reducing the incidence of hypotension during spinal anaesthesia.…”

Section: Discussionmentioning

confidence: 99%

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

et al. 2000

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This study was designed to determine the efficacy of oral etilefrine in preventing hypotension induced by spinal anaesthesia. Forty patients, ASA grade I or II, aged 23-60 years, scheduled for orthopaedic surgery involving the lower extremity under spinal anaesthesia were studied. The patients were randomly allocated to one of two groups; the etilefrine group (n = 20) received oral etilefrine 15 mg (30 drops), 60 min before the subarachnoid block, and the control group (n = 20) received no etilefrine. Patients were given 0.5% isobaric bupivacaine intrathecally. Hypotension was defined as a 30% decrease from base-line for systolic arterial pressure and mean arterial pressure or systolic value <90 mmHg, and was treated with intravenous boluses 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 pressure was significantly greater in the control group than in the etilefrine group (P < 0.05). The patients in the etilefrine group received less etilefrine supplement than those in control group and no subject in the etilefrine group required repeat etilefrine doses, while in the control group five patients received multiple etilefrine doses (P < 0.05). The mean heart rate remained fairly stable throughout the study periods. We conclude that oral etilefrine, given 60 min before surgery, reduces the fall in blood pressure during spinal anaesthesia.

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Prophylactic oral ephedrine reduces the incidence of hypotension after subarachnoid block

Abstract: Prophylactic oral ephedrine reduces the incidence of hypotension after subarachnoid block (1"3-1"4) and iv fluids, the total dose of ephedrine supplement in Group I was 4.3 + 4.8 mg compared with 11.6 + 9.4 mg in Group H (P < 0.01

Cited by 9 publications

References 6 publications

Prevention of Spinal Anesthesia Induced Hypotension in Elderly: Comparison of Prophylactic Atropine with Ephedrine

Prevention of Spinal Anesthesia Induced Hypotension in Elderly: Comparison of Prophylactic Atropine with Ephedrine

The efficacy of oral ephedrine in prevention of hypotension following spinal anesthesia in LSCS

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

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