A Comparison of Intravenous Ephedrine or Phenylephrine, for Prevention of Postspinal Hypotension during Elective Lower Abdominal Surgery: A Randomized, Double-blind Case–control Study

In this randomized, double‑blinded case–control study, we investigated the intravenous effects of ephedrine or phenylephrine on prevention of post–spinal hypotension in elective lower abdominal surgery under spinal anesthesia.

One hundred and thirty‑five patients, American Society of Anesthesiologists physical status I or II candidate for elective lower abdominal surgery under spinal anesthesia were randomized to three groups (45 each). According to their allocated group, patients received either ephedrine 2.5 mg (E group), phenylephrine (P group) 25 mic as vasopressor or the same volume of saline normal as placebo (S group) immediately after the spinal anesthesia. hemodynamic parameters, and complications were recorded.

Patients’ demographics were similar in all the groups. The mean systolic blood pressure (SBP), diastolic blood pressure (DBP), and MAP and also heart rate were similar over time for groups E and P (P > 0.05). The incidence of reactive hypertension was more in group E than group P and placebo (P < 0.05). The incidence of nausea and vomiting were significantly lower in groups E and P in comparison with placebo (P < 0.05).

Although the mean fall of SBP and DBP were significantly less in groups E and P compared with placebo but we did not find significant differences in prophylactic use of ephedrine or phenylephrine for prevention of post–spinal hypotension in elective lower abdominal surgery. Vasopressors infusion have added benefit of lower incidence of nausea and vomiting.