Abstract

Background: In the anesthesia practice prevention and management of hypotension related to spinal anesthesia remains a difficult problem and there was no consensus on its optimal management. The incidence of hypotension during spinal anesthesia for cesarean section is reported to be as high as 80%, despite fluid preload and lateral uterine displacement. Ephedrine, an indirectly acting sympathomimetic amine is probably the vasopressor of choice in obstetric anesthesia. Although ephedrine has mixed α and β adrenoreceptor activity it maintains arterial pressure mainly by increase in cardiac output and heart rate as a result of its predominant activity on β-1 adrenoreceptor. It may cause maternal tachycardia. It has less effect on uteroplacental blood flow as compared to other vasopressors.3
Objectives: This study was conducted to observe hemodynamic effects of ephedrine in spinal anesthesia during cesarean delivery on mother and to study the incidence of hypotension in the compared groups.
Methods: A prospective randomized double blind study. 100 ASA (American society of Anesthesiology) physical status I and II women undergoing elective cesarean delivery divided into study and control groups. Study group was received IV dose of 20 mg (2 ml) ephedrine over 60 seconds simultaneously with intrathecal dose of 2 ml 0.5% heavy bupivacaine. Control group was received IV 2 ml saline simultaneously with intrathecal dose of 2 ml 0.5% heavy bupivacaine.
Results: After 5 minutes mean pulse rate in group B is significantly lower than those of group A (p

Key words: Intravenous ephedrine, Spinal anesthesia, Cesarean delivery