Efficacy of intramuscular ephedrine in reducing the incidence of hypotension after spinal anaesthesia.

Abstract

􀀄with􀀄adverse􀀄effects􀀄like􀀄hypotension,􀀄bradycardia,􀀄post-spinal􀀄headache.􀀄Several􀀄options􀀄have􀀄been􀀄 tried􀀄to􀀄prevent􀀄spinal􀀄induced􀀄hypotension􀀄but􀀄the􀀄problem􀀄continues.􀀄Therefore􀀄this􀀄study􀀄was􀀄conducted􀀄 to􀀄 see􀀄 the􀀄 efficacy􀀄 of􀀄 prophylactic􀀄 intramuscular􀀄 ephedrine􀀄 in􀀄 reducing􀀄 the􀀄 incidence􀀄 of􀀄 spinal􀀄 induced􀀄 hypotension.􀀄Aims:􀀁To􀀄observe􀀄the􀀄outcome􀀄of􀀄prophylactic􀀄IM􀀄ephedrine􀀄on􀀄intraoperative􀀄hemodynamic􀀄 changes􀀄after􀀄spinal􀀄anaesthesia􀀄and􀀄also􀀄to􀀄see􀀄the􀀄incidence􀀄of􀀄hypotension􀀄after􀀄spinal􀀄anaesthesia􀀄Settings􀀈 and􀀈 Design:􀀁 Prospective􀀄 Randomised􀀄 Controlled􀀄 study􀀄 Methods􀀈 and􀀈 Material:􀀁 Study􀀄 was􀀄 conducted􀀄 on􀀄 108􀀄 patients􀀄 posted􀀄for􀀄elective􀀄lower􀀄 abdominal􀀄and􀀄 lower􀀄 limb􀀄surgeries􀀄under􀀄spinal􀀄 anaesthesia.􀀄Group􀀄A􀀄 received􀀄intramuscular􀀄ephedrine􀀄30mg􀀄(1ml),􀀄group􀀄B􀀄received􀀄intramuscular􀀄normal􀀄saline􀀄(1ml)􀀄as􀀄placebo􀀄 10􀀄minutes􀀄before􀀄spinal􀀄anesthesia.􀀄Patients􀀄were􀀄monitored􀀄for􀀄intraoperative􀀄hemodynamics,􀀄to􀀄see􀀄the􀀄 incidence􀀄 of􀀄 hypotension􀀄 and􀀄 also􀀄 to􀀄 see􀀄 any􀀄 adverse􀀄 side􀀄 effects􀀄 during􀀄 intraoperative􀀄 period.􀀈 Statistical􀀈 analysis􀀈 used:􀀁 To􀀄 find􀀄 the􀀄 significance􀀄 on􀀄 continuous􀀄 scale􀀄 between􀀄 two􀀄 groups,􀀄 Student􀀄 t􀀄 test􀀄 was􀀄 used.􀀄 Leven`s􀀄test􀀄used􀀄to􀀄find􀀄the􀀄homogeneity􀀄of􀀄variance.􀀄Chi-square/Fisher􀀄Exact􀀄test:􀀄used􀀄for􀀄significance􀀄of􀀄 categorical􀀄scale􀀄study􀀄 parameters􀀄between􀀄the􀀄groups,􀀄Fisher􀀄exact􀀄test􀀄is􀀄applied􀀄when􀀄samples􀀄are􀀄very􀀄 small.􀀄Results:􀀁Incidence􀀄of􀀄hypotension􀀄was􀀄more􀀄in􀀄group􀀄B􀀄and􀀄proven􀀄to􀀄be􀀄statistically􀀄significant􀀄when􀀄 compared􀀄to􀀄ephedrine􀀄group􀀄from􀀄2􀀄–􀀄20􀀄minutes.􀀄The􀀄numbers􀀄of􀀄patients􀀄receiving􀀄the􀀄rescue􀀄vasopressor􀀄 therapy􀀄was􀀄higher􀀄among􀀄in􀀄group􀀄B.􀀄There􀀄was􀀄no􀀄side􀀄effects􀀄observed􀀄in􀀄both􀀄the􀀄groups.􀀈Conclusions:􀀈 Intramuscular􀀄ephedrine􀀄when􀀄given􀀄prophylactically􀀄30mg,􀀄10􀀄minutes􀀄before􀀄spinal􀀄anaesthesia􀀄provides􀀄 better􀀄haemodynamic􀀄stability􀀄during􀀄intraoperative􀀄period􀀄without􀀄any􀀄side􀀄effects.