Fluid preloading versus ephedrine in the management of spinal anesthesia-induced hypotension in parturients undergoing cesarean delivery: a comparative study

Abstract

Introduction and objectives Spinal anesthesia-induced hypotension in parturients undergoing cesarean delivery is a very common complication that has detrimental effects on both the mother and the fetus. The objective of our study was to compare the two therapeutic modalities, fluid preloading and ephedrine, in the management of spinal anesthesia-induced hypotension in parturients undergoing elective cesarean delivery. Patients and methods A total of 50 ASA I-II parturient women who presented for cesarean section under spinal anesthesia were enrolled in this study. They were randomly assigned into two groups: the F group ( n = 25) (the fluid preloading group), which received 15 ml/kg of lactated Ringer's solution 10 min before spinal anesthesia, and the E group ( n = 25) (the ephedrine group), which received prophylactic 5 mg ephedrine first and second minute and 1 mg every minute until 15 min after the block. Hemodynamic variables and any postoperative complication were recorded. Results Demographic data and duration of procedures were comparable. Systolic blood pressure was generally higher in the E group than in the F group. However, the result was not statistically significant, except at 4 and 22 min after spinal anesthesia. Heart rate was higher in the E group than in the F group; however, it was not statistically significant. The incidence of hypotension and rescue boluses of ephedrine was significantly higher in the fluid group. Conclusion The use of ephedrine is superior to that of fluid preloading in maintaining blood pressure after spinal anesthesia in cesarean section.