Key result
Prophylactic ephedrine significantly reduced the incidence of hypotension compared to placebo (OR 0.117) during anesthesia induction with propofol and sufentanil in elderly hypertensive patients.
Why the study?
The study evaluated the effectiveness of prophylactic ephedrine to prevent hypotension caused by induction of anesthesia with propofol and sufentanil in elderly hypertensive patients.
Does prophylactic ephedrine prevent hypotension and bradycardia in elderly hypertensive patients undergoing general anesthesia induction with propofol and sufentanil?
RCT (n=70)
Double-blind
computerised random number generator
No
Does prophylactic ephedrine prevent hypotension and bradycardia in elderly hypertensive patients undergoing general anesthesia induction with propofol and sufentanil?
Odds Ratio: 0.117 (95% CI 0.04–0.347)
Absolute Event Rate: 28.6% vs 77.1%
p-value: p=0.008
Prophylactic administration of 100 ug/kg ephedrine significantly reduces the incidence of hypotension and bradycardia during anesthesia induction with propofol and sufentanil in elderly hypertensive patients.
Supports prophylactic ephedrine to prevent induction hypotension in elderly hypertensives; extends RCT evidence for vasopressor use in this population.
Objective: To study the effectiveness of prophylactic ephedrine to prevent hypotension caused by induction of anesthesia with propofol and sufentanil in elderly hypertensive patients. Methodology: 70 elderly ASA grade II-III hypertensive patients undergoing elective general anesthesia were randomized into two groups to receive either intravenous ephedrine,100 ug/kg in 5ml normal saline (Group B), or an equal volume of normal saline (Group A) before induction. Systolic Blood Pressure (SBP), Diastolic Blood Pressure (DBP) and Heart Rate (HR) were recorded at T0 (after entry to the operating room), T1 (1 min after induction), T2 (2 min after induction), T3 ( 3 min after induction), T4 (4 min after induction), T5 (when intubated), T6 (2 min after intubation), and T7 (at the start of the procedure), as well as the incidence of hypotension and bradycardia. Results: SBP, DBP and HR were not significantly different at T0 and were significantly different at T1 to T7 after anesthesia induction. There were statistically significant effect on hypotension and bradycardia between the two groups and group B have a lower risk of hypotension and bradycardia relative to group A. SBP and DBP decreased significantly after induction in both groups. HR decreased significantly in group A while increased in group B. Conclusion: Ephedrine pretreatment can minimize hypotension and bradycardia caused by propofol and sufentanil during the induction of general anesthesia in elderly patients with hypertension.
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A 2020 study conducted an RCT in Hypertension in elderly patients undergoing general anesthesia (n=70). Ephedrine vs. Normal saline was evaluated on Incidence of hypotension (OR 0.117, 95% CI 0.040-0.347, p=0.008). Prophylactic ephedrine significantly reduced the incidence of hypotension compared to placebo (OR 0.117) during anesthesia induction with propofol and sufentanil in elderly hypertensive patients.
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