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January 1, 2009Journal of Korean Medical ScienceOpen Access

The Effects of Intravenous Ephedrine During Spinal Anesthesia for Cesarean Delivery: A Randomized Controlled Trial

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Key result

Prophylactic intravenous ephedrine (0.5 mg/kg) significantly reduced the incidence of hypotension compared to saline control (38.1% vs. 85.7%, P<0.05) during spinal anesthesia for cesarean delivery.

Why the study?

Does prophylactic intravenous ephedrine reduce the incidence of hypotension in patients undergoing spinal anesthesia for cesarean delivery?

Population

42 patients undergoing spinal anesthesia for cesarean delivery

Comparison

Intravenous ephedrine 0.5 mg/kg injected over 60… vs Intravenous saline injected over 60 seconds…

Design

RCT, Randomly allocated into two groups, Double-blinded

Authors

İKİclal Özdemir KolSivas Cumhuriyet ÜniversitesiKKKenan KaygusuzSivas Cumhuriyet ÜniversitesiSGSinan GürsoySivas Cumhuriyet Üniversitesi

Discussion

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Implication

Supports prophylactic ephedrine in cesarean spinal anesthesia; confirms efficacy in this RCT.

Study Design

Type

RCT (n=42)

Blinding

Double-blind

Randomization

Computer-generated code

Multicenter

No

Structured PICO

Does prophylactic intravenous ephedrine reduce the incidence of hypotension in patients undergoing spinal anesthesia for cesarean delivery?

P
Population
42 healthy women (ASA I or II) undergoing elective cesarean section under spinal anesthesia, followed until umbilical cord clamping.
I
Intervention
Intravenous ephedrine 0.5 mg/kg injected over 60 seconds shortly after spinal injection, following an intravenous preload of 15 mL/kg lactated Ringer's solution
C
Comparator
Intravenous saline injected over 60 seconds shortly after spinal injection, following an intravenous preload of 15 mL/kg lactated Ringer's solution
O
Outcome
Incidence of hypotensionsurrogate

Main Result

Absolute Event Rate: 38.1% vs 85.7%

p-value: p=<0.05

Prophylactic intravenous ephedrine (0.5 mg/kg) significantly reduces the incidence of hypotension and associated nausea and vomiting during spinal anesthesia for cesarean delivery.

Limitations

  • Small sample size
  • Did not completely eliminate the need to treat maternal hypotension with rescue boluses
  • Did not measure uteroplacental blood flow

Cite This Study

Kol et al. (2009) conducted an RCT in Hypotension during spinal anesthesia for cesarean delivery (n=42). Intravenous ephedrine vs. Saline was evaluated on Incidence of hypotension (defined as 20% decrease in systolic arterial pressure from baseline) (p=<0.05). Prophylactic intravenous ephedrine (0.5 mg/kg) significantly reduced the incidence of hypotension compared to saline control (38.1% vs. 85.7%, P<0.05) during spinal anesthesia for cesarean delivery.

synapsesocial.com/papers/6a9152f6b18f518eae46427fhttps://doi.org/10.3346/jkms.2009.24.5.883
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Also Consider

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

  1. 1Role of Ephedrine for Management of Hypotension During Spinal Anaesthesia for Caesarean Delivery2018
  2. 2Prophylactic intravenous ephedrine for prevention of hypotension in cesarean section during spinal anesthesia: A comparative study2016 · 8 citations
  3. 3Volume Preload versus Ephedrine Infusion for Prevention of Hypotension Due to Spinal Anesthesia for Cesarean Section2016 · 7 citations
  4. 4Comparative study between ephedrine infusion vs. CO/post loading of fluids for prevention of hypotension in emergency cesarean section under spinal anesthesia2012 · 9 citations
  5. 5Ephedrine Infusion with Rescue Ephedrine Boluses versus Rescue Boluses alone for Preventing Hypotension during Spinal Anesthesia for Cesarean Delivery.2023