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Comparison of Prophylactic Intramuscular Ephedrine with Preloading Versus Preloading Alone in Prevention of Hypotension During Elective Caesarean Section Under Subarachnoid Block

College of Anaesthesiologists of Sri Lanka
Publication Date
  • Anaesthesiology
  • Subarachnoid Block
  • Hypotension
  • Ephedrine


Background: There is a considerable dispute over the use of different techniques for the prevention of hypotension during caesarean section under subarachnoid block. We hypothesize that crystalloid preloading together with prophylactic intramuscular (i.m.) ephedrine injection prevents occurrence of hypotension during caesarean section under subarachnoid block. The best protective dose of i.m ephedrine in relation to the appropriate time intervals, in order to prevent hypotension during caesarean section was assessed in this study. Method: Forty six healthy pregnant mothers were randomly allocated to five groups. Group A (control group) was given crystalloid preloading within 20 minutes (min) prior to subarachnoid block. Groups B and C received im ephedrine 15 mg 10 and 20 min prior to subarachnoid block whereas Groups D and E received im ephedrine 30 mg 10 and 20 min prior to subarachnoid block. All subjects in test groups were given crystalloid preloading within 20 min prior to subarachnoid block. Results: In the control group A, a significant mean arterial blood pressure(MAP) drop was observed at 5 min, 8min, 10min and 20 min time intervals(P < 0.01). A significant reduction in the mean arterial blood pressure was observed in Groups C and E and a significantly higher blood pressure was recorded in Group D. Group B steadily maintained the blood pressure at all time intervals without showing any significant changes. Conclusion: We conclude that preloading with crystalloid along with prophylactic im ephedrine 15mg given 10min prior to subarachnoid block will effectively prevent hypotension during cesarean section under subarachnoid block. Key Words: subarachnoid block, hypotension, ephedrine DOI: 10.4038/slja.v17i2.1298 Sri Lankan Journal of Anaesthesiology Vol.17(2) 2009 p.55-60

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