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October 18, 2019Open Access

Cardiac index increased significantly in the ephedrine group compared to saline (p=0.049) and phenylephrine (p=0.01) at the end of measurements.

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Why the study?

The study evaluated the influence of ephedrine or phenylephrine infusion given immediately after spinal anesthesia on hemodynamics in elderly orthopedic patients.

Does the infusion of ephedrine or phenylephrine prevent hemodynamic instability in elderly orthopedic patients after spinal anesthesia?

Population

70 elderly orthopedic patients receiving spinal anesthesia

Comparison

Ephedrine 20 mg vs phenylephrine 250 mcg vs saline infusion

Design

Prospective, randomized, double-blind, placebo-controlled study

Follow-up

30 minutes

Authors

MŽMiodrag ŽunićNŠNevenka Krčevski ŠkvarčMKMirt Kamenik

Discussion

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Overview

Ephedrine better preserves cardiac index than phenylephrine after spinal anesthesia in elderly patients; extends RCT evidence guiding vasopressor selection.

Structured PICO

Does the infusion of ephedrine or phenylephrine prevent hemodynamic instability in elderly orthopedic patients after spinal anesthesia?

P
Population
70 elderly orthopedic patients undergoing spinal anesthesia (subarachnoid injection of 15 mg levobupivacaine)
I
Intervention
Infusion of ephedrine 20 mg or phenylephrine 250 mcg within 30 minutes immediately after spinal anesthesia
C
Comparator
Saline infusion within 30 minutes immediately after spinal anesthesia
O
Outcome
Blood pressure, cardiac index (CI), and heart rate (HR) measured for 15 minutes before and 30 minutes after spinal anesthesiasurrogate

Immediate infusion of ephedrine or phenylephrine prevents hemodynamic instability after spinal anesthesia in elderly orthopedic patients, with ephedrine additionally maintaining heart rate and increasing cardiac index.

Cite This Study

Žunić et al. (2019) studied this question.

synapsesocial.com/papers/6a8a53a5bc8a49327d721f2bhttps://doi.org/10.21203/rs.2.10804/v3
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1The influence of the infusion of ephedrine and phenylephrine on the hemodynamic stability after subarachnoid anesthesia in senior adults - a controlled randomized trial2019 · 14 citations
  2. 2A Comparative Study of Infusion of Ephedrine and Phenylephrine on Hemodynamic Stability After Spinal Anesthesia in Elderly Patients Undergoing Lower Limb Orthopedic Surgeries2024 · 4 citations
  3. 3Comparison of efficacy and safety of preemptive infusion protocols of ephedrine and phenylephrine - prevention of hypotension and effects on hemodynamic parameters during spinal anesthesia for caesarean section2020 · 6 citations
  4. 4Comparison of the effect of different doses of phenylephrine infusion on the prevention of hypotension in the elderly under spinal anaesthesia in orthopaedic surgery2024
  5. 5The preventive role of prophylactic perioperative infusion of ephedrine versus noradrenaline in patients undergoing cesarean delivery under spinal anesthesia: a randomized prospective double-blinded study2026