Intrathecal ephedrine plus bupicaine for hernioraphy prophylaxis for hypotension and analgesic

Abstract

Background Usually, hernia repair is performed under spinal anesthesia. Hypotension secondary to spinal anesthesia is a common problem and many protocols have been tested regarding their efficacy in preventing this oweful complication. Aim of the work Compare the efficacy of intrathecal ephedrine plus Bupivacaine as prophylaxis for prevention of hypotension in patient undergoing inguinal hernia repair as compared to intrathecal Bupivacaine alone.as well as Does it have analgesic effect or not?.Patients and methods Eighty-four patients who underwent unilateral hernial were randomized to receive intratcal bupivacaine combined with ephedrine or receive intrathecal bupivacaine alone. The primary outcome was the effect of ephedrine on the hemodynamic profile. The secondary outcomes were the analgesic efficacy and the associated complications. Results In the current study, there was statistically significant decrease in the heart rate in the control group at the following duration during the intraoperative period. No cases in the test group showed bradycardia or hypotension. In the control group bradycardia occurred in 4 cases (16.7%) and hypotension occurred in 1 case (4.2%). The VAS score at 4 hours, 6 hours, 12 hours and 24 hours postoperative, the pain score were statistically significantly lower in the ephedrine group. Conclusion The use of ephedrine by the intrathecal route during spinal anesthesia was associated with better control of the hemodynamic parameters and lower incidence of bradycardia. As shown by lower VAS scores of pain, lower rescue analgesia doses, and longer first analgesic recall, ephedrine had a strong analgesic effect.