Ephedrine and dopamine's hypotension-preventative effect for CSEA in cesarean delivery-A single-blind controlled study

Abstract

Objective To compare the effects of ephedrine and dopamine in the prevention of hypotension during combined spinal and epidural anesthesia(CSEA)for cesarean delivery. Methods Fifty ASAⅠorⅡpatients undergoing elective cesarean delivery were randomly divided into the two groups, Ephedrine group(n =51): intravenous injection of 10mg ephedrine before anesthesia; Dopamine group(n=52): continuous intravenous infusion at the speed of 5μg·kg-1·min-1.During the whole process, we investigated the incidence rate of adverse effects, compared the Apgar score of neonate and analyzed blood gas of umbilical artery and vein. Results Compare to the dopamine group, the incidence rate of hypotension was lower in the ephedrine group(43.1%vs 69.2%,χ2=7.06,P=0.00). The p H value of umbilical artery and 1 min Apgar score of neonate in the ephedrine group was lower compare with that in the dopamine group[(7.22±0.03)vs(7.27±0.06),t=0.62, P=0.02], there are no significant difference of 5min Apgar score in the two groups. Conclusion Compared with dopamine, ephedrine is a useful drug in the prevention of hypotension during combined spinal and epidural anesthesia(CSEA)for cesarean delivery and there are no significant differences of adverse effects of dopamine and ephedrine. Ephedrine has transient effect on the neonate, while the effect of dopamine is minor. Key words: Cesarean section; Anesthesia; Ephedrine; Dopamine