TY - JOUR
T1 - Prevention of maternal hypotension by epidural administration of ephedrine sulfate during lumbar epidural anesthesia for cesarean section
AU - Fong, J.
AU - Gurewitsch, E. D.
AU - Press, R. A.
AU - Gomillion, M. C.
AU - Volpe, L.
PY - 1996
Y1 - 1996
N2 - OBJECTIVE: Our purpose was to determine whether epidural administration of ephedrine sulfate simultaneously with induction of lumbar epidural anesthesia for nonemergency cesarean section reduces the incidence of maternal hypotension. STUDY DESIGN: In a double-blinded, placebo-controlled trial, 50 normotensive, nonlaboring, American Society of Anesthesiologists' class I or II women with term, uncomplicated, singleton pregnancies were randomly assigned to have normal saline solution or ephedrine sulfate administered epidurally and coincidentally with induction of lumbar epidural anesthesia for nonemergency cesarean section. All subjects were prehydrated with 25 ml/kg crystalloid and pieced in supine position on a 15-degree, right-sided wedge before and after induction. Serial blood pressures were compared with baseline blood pressures, chosen as the average of three preinduction blood pressures. Hypotension was defined as a decline in systolic blood pressure to ≤90 mm Hg or ≤70% of baseline. Differences between groups were analyzed by Fisher's Exact Test. Significance was determined at p < 0.05. RESULTS: The incidence of hypotension in the control group was 24%, which was not significantly different from the incidence of 32% in the treated group. CONCLUSION: Prophylactic epidural administration of ephedrine sulfate does not reduce the incidence of maternal hypotension after lumbar epidural anesthesia for nonemergency cesarean section.
AB - OBJECTIVE: Our purpose was to determine whether epidural administration of ephedrine sulfate simultaneously with induction of lumbar epidural anesthesia for nonemergency cesarean section reduces the incidence of maternal hypotension. STUDY DESIGN: In a double-blinded, placebo-controlled trial, 50 normotensive, nonlaboring, American Society of Anesthesiologists' class I or II women with term, uncomplicated, singleton pregnancies were randomly assigned to have normal saline solution or ephedrine sulfate administered epidurally and coincidentally with induction of lumbar epidural anesthesia for nonemergency cesarean section. All subjects were prehydrated with 25 ml/kg crystalloid and pieced in supine position on a 15-degree, right-sided wedge before and after induction. Serial blood pressures were compared with baseline blood pressures, chosen as the average of three preinduction blood pressures. Hypotension was defined as a decline in systolic blood pressure to ≤90 mm Hg or ≤70% of baseline. Differences between groups were analyzed by Fisher's Exact Test. Significance was determined at p < 0.05. RESULTS: The incidence of hypotension in the control group was 24%, which was not significantly different from the incidence of 32% in the treated group. CONCLUSION: Prophylactic epidural administration of ephedrine sulfate does not reduce the incidence of maternal hypotension after lumbar epidural anesthesia for nonemergency cesarean section.
KW - Ephedrine sulfate
KW - epidural
KW - maternal hypotension
KW - obstetric anesthesia
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U2 - 10.1016/S0002-9378(96)80038-X
DO - 10.1016/S0002-9378(96)80038-X
M3 - Article
C2 - 8885761
AN - SCOPUS:0029907982
SN - 0002-9378
VL - 175
SP - 985
EP - 990
JO - American journal of obstetrics and gynecology
JF - American journal of obstetrics and gynecology
IS - 4 I
ER -