Use of Intravenous Ephedrine in Crystalloid Preload to Decrease the Preload Volume Requirement Before Spinal Anesthesia in Elective Cesarean Section

Abstract

Objective: To determine the use of intravenous Ephedrine in crystalloid preload before spinal anesthesia in elective cesarean section to prevent hypotension to avoid detrimental effects of hypotension in obstetric patients. Study Design: Quasi-experimental study. Place and Duration of Study: Combined Military Hospital, Rawalpindi Pakistan, from Sep 2021 to Feb 2022. Methodology: A total of (250) full-term parturients (>36 weeks gestation) with an age range of 20 to 35 years, scheduled for elective cesarean section belonging to the American Society of anaesthesiologists classification II were included in the study. Bradycardia and tachycardia were endorsed as 30% of baseline respectively whereas <20% decline in systolic blood pressure was labeled as hypotension. Hemodynamic profile, nausea, vomiting, and Appearance, Pulse, Grimace, Activity and Respiration scores were recorded. Results: A total of 250 full-term pregnant patients with a mean age of 25.23±4.15. belonging to American Society of anaesthesiologists II in enrolled in the study. Among Group–E 18(14.4%) experienced hypotension whereas 67(53.6%) participants had a frequency of hypotension in Group–F (p-value <0.001), hence greater number of parturients in Group–F 67(53.6%) were administered ≥ 10 mg rescue Ephedrine bolus as compared to 18(14.4%) participants of Group–E (p-value <0.001). Conclusion: This study concluded that prophylactic administration of intravenous Ephedrine as a bolus dose can significantly alleviate the frequency of hypotension in obstetric patients with negligible adverse effects profile on the mother and neonate.

Keywords

• Bolus, Ephedrine, Gestation, Hypotension, Normal saline