Comparison of prophylactic ephedrine with crystalloid preloading for prevention of hypotension due to spinal anaesthesia for caesarian sections

Abstract

Background: Hypotension is the usual complication of spinal anaesthesia in cesarean section. The present study was done to compare the efficiency of Ephedrine infusion and crystalloid preloading for the prevention of postspinal hypotension. Methodology: This study was conducted on sixty patients who were randomly divided into two groups of 30 patients each. Group I (n = 30) received 15 ml/kg of lactated Ringer's solution 10 min before spinal anaesthesia, and Group-II (n = 30) received prophylactic 5 mg ephedrine first and second minute and 1 mg every minute until 15 min after the spinal anaesthesia. Heart rate and systolic blood pressure were measured at 1min after spinal anaesthesia, and then every 3 minutes for the first 30 minutes then every 5 minutes for the next 30 minutes and then after 30 minutes. O2 saturation was recorded every 30 minutes. Observations and Results: incidence of Hypotension was significantly higher in the group I (40%) compared to the group II (20%) (p-value 0.01). There is a significant fall in SBP in a fluid group compared to the Ephedrine group. Significant increase in the incidence of nausea and vomiting was observed in the group I (17%) when compared to the group II (3%), (p-value 0.02) and non significant increase in the incidence of Bradycardia was observed in group I (20%) when compared to group II (3%), (p-value 0.2). Conclusion: IV infusion of ephedrine was found to be very effective compared to crystalloid preloading in the prevention of hypotension in patients receiving spinal anaesthesia for cesarean section.