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Article: Prevention of hypotension during spinal anaesthesia for Caesarean section: Ephedrine infusion versus fluid preload

TitlePrevention of hypotension during spinal anaesthesia for Caesarean section: Ephedrine infusion versus fluid preload
Authors
Issue Date1997
PublisherWiley-Blackwell Publishing Ltd.. The Journal's web site is located at http://www.wiley.com/bw/journal.asp?ref=0003-2409
Citation
Anaesthesia, 1997, v. 52 n. 9, p. 908-913 How to Cite?
AbstractWe 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 ≤ 20% reduction in systolic blood pressure and severe hypotension as ≤ 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 seven 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 us. 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.
Persistent Identifierhttp://hdl.handle.net/10722/147181
ISSN
2015 Impact Factor: 3.794
2015 SCImago Journal Rankings: 1.404
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorChan, WSen_US
dc.contributor.authorIrwin, MGen_US
dc.contributor.authorTong, WNen_US
dc.contributor.authorLam, YHen_US
dc.date.accessioned2012-05-29T06:00:37Z-
dc.date.available2012-05-29T06:00:37Z-
dc.date.issued1997en_US
dc.identifier.citationAnaesthesia, 1997, v. 52 n. 9, p. 908-913en_US
dc.identifier.issn0003-2409en_US
dc.identifier.urihttp://hdl.handle.net/10722/147181-
dc.description.abstractWe 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 ≤ 20% reduction in systolic blood pressure and severe hypotension as ≤ 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 seven 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 us. 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.en_US
dc.languageengen_US
dc.publisherWiley-Blackwell Publishing Ltd.. The Journal's web site is located at http://www.wiley.com/bw/journal.asp?ref=0003-2409en_US
dc.relation.ispartofAnaesthesiaen_US
dc.subject.meshAnesthesia, Obstetrical - Adverse Effectsen_US
dc.subject.meshAnesthesia, Spinal - Adverse Effectsen_US
dc.subject.meshCesarean Sectionen_US
dc.subject.meshEphedrine - Therapeutic Useen_US
dc.subject.meshFemaleen_US
dc.subject.meshHeart Rate - Drug Effectsen_US
dc.subject.meshHumansen_US
dc.subject.meshHypotension - Etiology - Prevention & Controlen_US
dc.subject.meshIntraoperative Perioden_US
dc.subject.meshIsotonic Solutionsen_US
dc.subject.meshPlasma Substitutes - Therapeutic Useen_US
dc.subject.meshPregnancyen_US
dc.subject.meshPregnancy Outcomeen_US
dc.subject.meshRehydration Solutions - Therapeutic Useen_US
dc.subject.meshUterus - Blood Supplyen_US
dc.subject.meshVasoconstrictor Agents - Therapeutic Useen_US
dc.titlePrevention of hypotension during spinal anaesthesia for Caesarean section: Ephedrine infusion versus fluid preloaden_US
dc.typeArticleen_US
dc.identifier.emailIrwin, MG:mgirwin@hku.hken_US
dc.identifier.authorityIrwin, MG=rp00390en_US
dc.description.naturelink_to_subscribed_fulltexten_US
dc.identifier.pmid9349079en_US
dc.identifier.scopuseid_2-s2.0-0030924591en_US
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-0030924591&selection=ref&src=s&origin=recordpageen_US
dc.identifier.volume52en_US
dc.identifier.issue9en_US
dc.identifier.spage908en_US
dc.identifier.epage913en_US
dc.identifier.isiWOS:A1997XX61000019-
dc.publisher.placeUnited Kingdomen_US

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