THE EFFECT OF EPHEDRINE AND PLACEBO ON HEMODYNAMIC CHANGES AND ITS COMPLICATIONS IN PATIENTS UNDERGOING PERCUTANEOUS NEPHROLITHOTOMY WITH SPINAL ANESTHESIA

Nephrolithiasis is one of the common diseases that is seen in one case out of thirteen women and one case out of seven men. The aim of this study was to compare the effect of prophylactic Phenylephrine in the prevention of hypotension during spinal anesthesia percutaneous nephrolithotomy surgery.

In this experimental study, 60 patients undergoing percutaneous nephrolithotomy surgery with ASA I and II, were randomized to receive prophylaxis with ephedrine or placebo immediately before the spinal anesthesia. Patients in the ephedrine group received an intravenous bolus of 10 mg ephedrine. Mean arterial, systolic and diastolic blood pressure, heart rate, nausea, and vomiting during surgery and recovery were recorded.

The incidence of blood pressure drop in the ephedrine group was lower than spinal anesthesia in 3, 6, 9 and 15 minutes (P values were 0.01, 0.03, 0.04, and 0.03, respectively). There were no significant differences between two groups in heart rate in different time of study (P>0.05). In the Ephedrine group, the incidence of nausea and vomiting during and after surgery was significantly lower (P values were 0.03, 0.04, 0.04, 0.03, respectively).

At the dose of ephedrine administered in this trial, the ability of this drug to prevent hypotension during percutaneous nephrolithotomy surgery with spinal anesthesia was significant. Higher incidences of hypotension were observed in the placebo group.