Intramuscular Ephedrine in Reducing the Incidence of Hypotension After Spinal Anaesthesia

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Intramuscular Ephedrine in Reducing the Incidence of Hypotension After Spinal Anaesthesia

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Context: Spinal anaesthesia remains one of the basic and important technique in the modern period, but associated with adverse effects like hypotension, bradycardia, post-spinal headache. Several options have been tried to prevent spinal induced hypotension but the problem continues. Therefore this study was conducted to see the efficacy of prophylactic intramuscular ephedrine in reducing the incidence of spinal induced hypotension. Aims: To observe the outcome of prophylactic IM ephedrine on intraoperative hemodynamic changes after spinal anaesthesia and also to see the incidence of hypotension after spinal anaesthesia Settings and Design: Prospective Randomised Controlled study Methods and Material: Study was conducted on 108 patients posted for elective lower abdominal and lower limb surgeries under spinal anaesthesia. Group A received intramuscular ephedrine 30mg (1ml), group B received intramuscular normal saline (1ml) as placebo 10 minutes before spinal anesthesia. Patients were monitored for intraoperative hemodynamics, to see the incidence of hypotension and also to see any adverse side effects during intraoperative period. Statistical analysis used: To find the significance on continuous scale between two groups, Student t test was used. Leven`s test used to find the homogeneity of variance. Chi-square/Fisher Exact test: used for significance of categorical scale study parameters between the groups, Fisher exact test is applied when samples are very small. Results: Incidence of hypotension was more in group B and proven to be statistically significant when compared to ephedrine group from 2 – 20 minutes. The numbers of patients receiving the rescue vasopressor therapy was higher among in group B. There was no side effects observed in both the groups. Conclusions: Intramuscular ephedrine when given prophylactically 30mg, 10 minutes before spinal anaesthesia provides better haemodynamic stability during intraoperative period without any side effects.

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