Comparison of the Hemodynamic Effects of Pretreatment with Crystalloids Versus Crystalloids Plus Ephedrine During Spinal Anesthesia for Caesarean Section.

Prevention of hypotension during spinal anesthesia for cesarean section avoids maternal and fetal side effects. The aim of this study was to compare the effects of the combination of ephedrine crystalloid and prehydration with crystalloid alone on maternal blood pressure and neonatal outcome during cesarean section under spinal anesthesia. We enrolled 72 full term women weighing between 50 and 75 Kg, classified as ASA I, scheduled for elective caesarean section under spinal anesthesia. Participants were randomly allocated to either the ephedrine or crystalloid group. After arrival in the operating room and intravenous (IV) access, 10 ml/Kg of ringer solution was infused 10-15 minutes before the initiation of the spinal block, but in the ephedrine group, an additional 10mg of ephedrine was added to the solution for infusion. In the crystalloid group, a placebo was added to the solution. Hypotension occurred in 55.6% of patients in the crystalloid group and in 25% of patients in the ephedrine group. The difference between the two groups was found to be statistically significant (P = 0.008), however, there was no significant difference in mean systolic blood pressure between the two groups (105.61± 7.13 in crystalloid group vs. 107.89 ± 9.84 in ephedrine group). Apgar scores in newborns were above 8 in both groups. Prophylactic ephedrine given by infusion in combination with crystalloid was more effective than crystalloid prehydration in the prevention of hypotension during spinal anesthesia for elective caesarean section.