skip to main content

Comparison of Intravenous Ephedrine Administration of 5 mg and 10 mg Doses on Post Spinal Anesthesia Hypotension in Caesarean Section at Dr. Kariadi General Hospital Semarang

Husein Alaydrus  -  Faculty of Medicine, Diponegoro University, Semarang, Indonesia, Indonesia
*Amar Rayhan orcid  -  Faculty of Medicine, Diponegoro University, Indonesia, Indonesia
Johan Arifin  -  Department of Anesthesiology and Intensive Therapy, Faculty of Medicine, Diponegoro University/Dr. Kariadi General Hospital, Semarang, Indonesia, Indonesia
Hari Hendriarto Satoto  -  Department of Anesthesiology and Intensive Therapy, Faculty of Medicine, Diponegoro University/Dr. Kariadi General Hospital, Semarang, Indonesia, Indonesia
Open Access Copyright (c) 2025 Diponegoro International Medical Journal
Creative Commons License This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.

Citation Format:
Abstract

Background: Hypotension after spinal anesthesia or combined epidural anesthesia in caesarean section (CS) causes adverse effects on the mother and fetus/neonatal. Hypotension often occurs therefore vasopressors could be used routinely and should be used as prophylaxis

Methods: Simple randomized controlled trial study of 52 patients undergoing CS at RSUP dr. Kariadi Semarang. Subjects revealed two groups, namely intravenous ephedrine at a dose of 5 mg and a dose of 10 mg. Hemodynamic variables were measured every 3 minutes until the operation was completed.

Results: In the comparison of mean arterial pressure (MAP) between the ephedrine 5 mg and ephedrine 10 mg groups, a statistically significant difference was obtained at 30 minutes (P < 0.05) while in the measurement of heart rate (HR) between the ephedrine 5 group mg and ephedrine 10 mg, a statistically significant difference was obtained from 3 to 15 minutes. Hypotension was obtained in 1 patient in the ephedrine 10 mg group and 3 patients in the ephedrine 5 mg group.

Conclusion: 10 mg intravenous ephedrine as a prophylactic agent after spinal anesthesia for patients undergoing CS has better hemodynamic outcomes and complications than 5 mg intravenous ephedrine.

 

Keywords: spinal anesthesia, ephedrine, SC, hypotension

Fulltext View|Download
Keywords: spinal anesthesia, ephedrine, SC, hypotension

Article Metrics:

  1. Datta S, Kodali BS, Segal S. Relief of Labor Pain by Regional Analgesia/Anesthesia BT - Obstetric Anesthesia Handbook: Fifth Edition. In: Datta S, Kodali BS, Segal S, editors. New York, NY: Springer New York; 2010. p. 107–49. Available from: https://doi.org/10.1007/978-0-387-88602-2_9
  2. Taylor CR, Dominguez JE, Habib AS. Obesity And Obstetric Anesthesia: Current Insights. Local Reg Anesth. 2019;12:111–24
  3. Faccenda KA, Finucane BT. Complications of regional anaesthesia Incidence and prevention. Drug Saf. 2001;24(6):413–42
  4. Kol IO, Kaygusuz K, Gursoy S, Cetin A, Kahramanoglu Z, Ozkan F, et al. The effects of intravenous ephedrine during spinal anesthesia for cesarean delivery: a randomized controlled trial. J Korean Med Sci. 2009 Oct;24(5):883–8
  5. Turkoz A, Togal T, Gokdeniz R, Toprak HI, Ersoy O. Effectiveness of intravenous ephedrine infusion during spinal anaesthesia for caesarean section based on maternal hypotension, neonatal acid-base status and lactate levels. Anaesth Intensive Care. 2002 Jun;30(3):316–20
  6. Ngan Kee WD, Khaw KS, Lee BB, Lau TK, Gin T. A dose-response study of prophylactic intravenous ephedrine for the prevention of hypotension during spinal anesthesia for cesarean delivery. Anesth Analg. 2000;90(6):1390–5
  7. Kulkarni KR, Naik AG, Deshpande SG. Evaluation of antihypotensive techniques for cesarean section under spinal anesthesia: Rapid crystalloid hydration versus intravenous ephedrine. Anesth essays Res. 2016;10(3):637–42
  8. Lashari A, Chachar AZ, Rana M, Qayyum MA, Siddiqui M, Shaheen H. Role of Prophylactic Bolus Dose of Ephedrine to Prevent Hypotension after Spinal Anesthesia; A Single Center Experience. Pakistan J Med Heal Sci. 2021 Aug 26;15:2039–42
  9. Singh TH, Thokchom RS, Sinam M, Nongthonbam R, Devi MB, Singh KM. Prophylactic intravenous ephedrine for prevention of hypotension in cesarean section during spinal anesthesia: A comparative study. JMS - J Med Soc. 2016 Jan 1;30:116–20
  10. Xue X, Lv X, Ma X, Zhou Y, Yu N, Yang Z. Prevention of spinal hypotension during cesarean section: A systematic review and Bayesian network meta-analysis based on ephedrine, phenylephrine, and norepinephrine. J Obstet Gynaecol Res. 2023 Jul;49(7):1651–62
  11. Kinsella SM, Carvalho B, Dyer RA, Fernando R, Mcdonnell N, Mercier FJ, et al. International consensus statement on the management of hypotension with vasopressors during caesarean section under spinal anaesthesia. 2018;71–92
  12. Anesth J, Crit A, Herbosa GAB, Tho NN, Gapay AA, Lorsomradee S. Consensus on the Southeast Asian management of hypotension using vasopressors and adjunct modalities during cesarean section under spinal anesthesia. J Anesth Analg Crit Care [Internet]. 2022;1–16. Available from: https://doi.org/10.1186/s44158-022-00084-1
  13. Tihtonen K, Kööbi T, Yli-Hankala A, Uotila J. Maternal hemodynamics during cesarean delivery assessed by whole-body impedance cardiography. Acta Obstet Gynecol Scand. 2005 Apr;84(4):355–61
  14. Bank TC, Macones G, Sciscione A. The “30-minute rule” for expedited delivery: fact or fiction? Am J Obstet Gynecol [Internet]. 2023 May 1;228(5):S1110–6. Available from: https://doi.org/10.1016/j.ajog.2022.06.015

Last update:

No citation recorded.

Last update:

No citation recorded.