Dataset Information

Comparison of an ephedrine infusion with lidocaine %5 for prevention of hypotension during spinal anesthesia in cesarean section.

ABSTRACT: Background:Spinal anesthesia is the method of choice for cesarean section and in most cases causes hypotension. Objective:The aim of this study was to treat hypotension by ephedrine in order to prevent maternal and fetal complications, and also to determine the effective amount of ephedrine for reducing arterial hypertension in order to prevent its complications, including cardiac arrhythmias. Method:This cross-sectional descriptive study was conducted on 131 patients. Mean arterial blood pressure (MAP) of the candidates for cesarean section in the supine position was measured and recorded as mean baseline blood pressure. 75 mg of lidocaine (5%) was used as spinal anesthesia, following which the average blood pressure was measured every 1 min. In the event of a decrease in the mean arterial blood pressure of at least 20% of the mean baseline blood pressure, ephedrine 0.1/mg/kg was injected intravenously and after 1 min of MAP was measured. Result:The prevalence of hypotension was 89.30%. 25.60% of patients with hypotension had 30-34.99% reduction in MAP compared to baseline MAP. 12% patients had 40% drop in their MAP. 4 min following spinal anesthesia, the incidence of hypotension reduced by 20%. The average dose of ephedrine required to reduce the incidence of hypotension was 20.5 mg. Conclusion:Reduction in MAP following spinal anesthesia using lidocaine is common. Ephedrine at the dose of 20 mg is effective to reduce the incidence of perioperative hypotension.

SUBMITTER: Pouryaghobi SM

PROVIDER: S-EPMC8666525 | biostudies-literature |

REPOSITORIES: biostudies-literature

ACCESS DATA

Similar Datasets

Project description:BackgroundNorepinephrine infusion decreases hypotension after spinal anesthesia during cesarean section. This study aimed to compare the efficacy of norepinephrine infusion and ephedrine bolus against post-spinal hypotension in parturients.MethodsIn this double-blinded, randomized controlled clinical trial, parturients scheduled for elective cesarean section were randomly allocated to receive norepinephrine infusion (0.05 μg·kg-1·min-1) just before spinal anesthesia continuing for 30 min or ephedrine bolus (0.15 mg/kg) just before spinal anesthesia. A rescue bolus (5 μg norepinephrine for the norepinephrine group, and 5 mg ephedrine for the ephedrine group) was administered whenever hypotension occurred. Our primary outcome was the incidence of hypotension within 30 min of spinal anesthesia administration. Secondary outcomes included maternal and neonatal outcomes 30 min after spinal block, and neonatal cerebral oxygenation 10 min after birth.ResultsIn total, 190 patients were enrolled; of these patients, 177 were included in the final analysis. Fewer patients suffered hypotension in the norepinephrine group than in the ephedrine group (29.5% vs. 44.9%, odds ratio [OR]: 0.51, 95% confidence interval [CI]: 0.28-0.95, P = 0.034). Moreover, the tachycardia frequency was lower in the norepinephrine group than in the ephedrine group (OR: 0.22, 95% CI: 0.11-0.44, P < 0.001), and patients suffered less nausea and vomiting (OR: 0.28, 95% CI: 0.11-0.70, P = 0.004). There was no difference in Apgar scores and umbilical arterial blood gas analysis between the two groups. However, neonatal cerebral regional saturations were significantly higher after birth in the norepinephrine group than in the ephedrine group (mean difference: 2.0%, 95% CI: 0.55%-3.45%, P = 0.008).ConclusionIn patients undergoing elective cesarean section with spinal anesthesia, norepinephrine infusion compared to ephedrine bolus resulted in less hypotension and tachycardia, and exhibited potential neonatal benefits.Trial registrationClinicalTrials.gov, NCT02542748; https://clinicaltrials.gov/ct2/show/record/NCT02542748.

Project description:BackgroundSpinal anesthesia is the standard technique for elective cesarean section, but the incidence of maternal hypotension in this setting is reportedly about 80%, without any prophylactic management. Vasopressors are the most reliable method for counteracting the hypotension induced by spinal anesthesia. However, studies investigating the effects of vasopressors have yielded inconsistent and debatable results. Therefore, we plan to conduct a systematic review and network meta-analysis to identify the most effective vasopressor to prevent maternal hypotension, and to decrease fetal acidosis in women undergoing spinal anesthesia for elective cesarean section.MethodsA systematic and comprehensive search to detect all the randomized controlled studies on vasopressors for the management of maternal hypotension during cesarean section under spinal anesthesia will be performed using information in the databases, MEDLINE, EMBASE, the Cochrane Central Register of Controlled Trials (CENTRAL), and Google Scholar, beginning from their inception to October 2018. We will conduct a network meta-analysis to combine the direct and indirect comparisons of the vasopressors. We will use the surface under the cumulative ranking curve (SUCRA) values and rankograms to present the hierarchy of vasopressors. A comparison-adjusted funnel plot will be used to assess the presence of small-study effects. The quality of the studies included will be assessed using the risk of bias tool. All statistical analyses will be performed using Stata SE version 15.0.Ethics and disseminationThis systematic review and meta-analysis will be published in a peer-reviewed journal. Ethical approval and informed consent are not required, as the study will be a literature review and will not involve direct contact with patients or alterations to patient care.Trial registration numberThe protocol for this review has been registered in the PROSPERO network (registration number: CRD42018111852).

Dataset Information

Comparison of an ephedrine infusion with lidocaine %5 for prevention of hypotension during spinal anesthesia in cesarean section.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets