Document Detail


Prevention of hypotension during spinal anaesthesia for caesarean section: ephedrine infusion versus fluid preload.
MedLine Citation:
PMID:  9349079     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
We compared the efficacy of prophylactic ephedrine infusion over fluid preloading in prevention of maternal hypotension during spinal anaesthesia for Caesarean section. Forty-six women undergoing elective Caesarean section at term were allocated randomly to receive either intravenous fluid preloading with Hartmann's solution 20 ml.kg-1 (fluid group) or prophylactic intravenous ephedrine 0.25 mg.kg-1 (ephedrine group). Moderate hypotension was defined as > or = 20% reduction in systolic blood pressure and severe hypotension as > or = 30% reduction in systolic blood pressure. Maternal uterine circulation was measured using Doppler ultrasound in 11 parturients before and after spinal anaesthesia. There was a lower incidence of severe hypotension in the ephedrine group compared with the fluid group (35% vs. 65%, p = 0.04), although the incidence of moderate hypotension was similar. Mean umbilical venous pH was higher in the ephedrine group than in the fluid group (7.33 vs. 7.29, p = 0.02) and the number of patients shivering was lower in the ephedrine group (2 vs. 9, p = 0.02). No difference was found between pre- and postspinal uterine artery pulsatility indices in either group. We conclude that prophylactic ephedrine infusion alone is at least as good as fluid preload alone in combating the hypotension associated with spinal anaesthesia for Caesarean section.
Authors:
W S Chan; M G Irwin; W N Tong; Y H Lam
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  Anaesthesia     Volume:  52     ISSN:  0003-2409     ISO Abbreviation:  Anaesthesia     Publication Date:  1997 Sep 
Date Detail:
Created Date:  1997-11-13     Completed Date:  1997-11-13     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0370524     Medline TA:  Anaesthesia     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  908-13     Citation Subset:  AIM; IM    
Affiliation:
Department of Anaesthesiology, University of Hong Kong, Queen Mary Hospital, People's Republic of China.
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MeSH Terms
Descriptor/Qualifier:
Anesthesia, Obstetrical / adverse effects*
Anesthesia, Spinal / adverse effects*
Cesarean Section*
Ephedrine / therapeutic use*
Female
Heart Rate / drug effects
Humans
Hypotension / etiology,  prevention & control*
Intraoperative Period
Isotonic Solutions
Plasma Substitutes / therapeutic use
Pregnancy
Pregnancy Outcome
Rehydration Solutions / therapeutic use
Uterus / blood supply
Vasoconstrictor Agents / therapeutic use*
Chemical
Reg. No./Substance:
0/Isotonic Solutions; 0/Plasma Substitutes; 0/Rehydration Solutions; 0/Vasoconstrictor Agents; 0/crystalloid solutions; 299-42-3/Ephedrine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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