The haemodynamic effects of propofol in combination with ephedrine

Forty ASA1 patients presenting for minor gynaecological surgery were randomly allocated into four study groups to compare the haemodynamic effects of adding different doses of ephedrine to an induction dose of propofol. Heart rate, oxygen saturation and non-invasive arterial blood pressure were monitored before and for 5 min after induction. In those patients who received propofol alone, there was a significant decrease in both systolic (p < 0.001) and diastolic (p = 0.003) blood pressure. The addition of ephedrine 15 mg or 20 mg to 1% propofol 20 ml was very effective in maintaining blood pressure at pre-induction values. There was a statistically significant increase from baseline in systolic (p = 0.004) and diastolic (p = 0.031) pressures, but this only occurred at 1 min postinduction. The addition of ephedrine 10 mg was insufficient to prevent hypotension. There was no significant effect on either heart rate or oxygen saturation in any group. We conclude that ephedrine may be safely employed to reduce the degree of hypotension during induction with propofol in this patient group.