Key result
Prophylactic intravenous ephedrine prevented spinal-induced hypotension in 74% of women undergoing cesarean section, compared to 50% of those receiving a fluid preload (p=0.013).
Why the study?
Fluid preloading to reduce spinal anesthesia-induced hypotension is time-consuming and often requires vasopressors, while prophylactic ephedrine lowers hypotension risk but may cause reactive hypertension.
Does prophylactic ephedrine prevent hypotension better than fluid preload in women undergoing cesarean section under spinal anesthesia?
Comparison
Prophylactic ephedrine vs fluid (Hartmann's solution) preload
Design
Randomized controlled trial
Follow-up
Fifteen minutes
Authors
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Prophylactic ephedrine reduces post-spinal hypotension risk; extends RCT evidence in obstetrics while highlighting side-effect trade-offs.
RCT (n=100)
Sealed envelopes (draws method)
No
Does prophylactic ephedrine prevent hypotension better than fluid preload in women undergoing cesarean section under spinal anesthesia?
Absolute Event Rate: 74% vs 50%
p-value: p=0.013
Prophylactic ephedrine is more effective than fluid preload with Hartmann's solution in preventing hypotension during spinal anesthesia for cesarean section.
Ali et al. (2022) conducted an RCT in Hypotension during spinal anesthesia for cesarean section (n=100). Prophylactic ephedrine vs. Fluid preload (20 ml/kg Hartmann's solution) was evaluated on Prevention of hypotension (>20% decrease in systolic and/or diastolic blood pressure from baseline) (p=0.013). Prophylactic intravenous ephedrine prevented spinal-induced hypotension in 74% of women undergoing cesarean section, compared to 50% of those receiving a fluid preload (p=0.013).