The Effect of Volume Preload versus Ephedrine Infusion for Prevention of Hypotension due to Spinal Anesthesia for Cesarean Section

Abstract

Abstract Background Spinal anesthesia is the preferred method for elective cesarean sections due to considerable risks regarding airway management associated with physiological changes of pregnancy. We hypothesized that using ephedrine to maintain maternal blood pressure during spinal anesthesia for cesarean delivery provides better hemodynamic stability with subsequent better maternal and neonatal outcomes compared to volume preload. Aim of the Work We compared volume preload and ephedrine infusion to guard against the hypotensive effect of spinal anesthesia during cesarean delivery. Patients and Methods After obtaining approval from the Research Ethical Committee of Faculty of Medicine, Ain Shams University, and written informed consent this study was conducted in the operating theaters of Ain Shams University Hospitals. This study was a randomized Controlled Clinical Trial. Adult parturients undergoing cesarean section under spinal anesthesia randomly assigned into one of the following groups using computer generated codes and opaque sealed envelopes: Group (A) received Volume Preload, group (B) received Ephedrine Infusion. Results The results of the study showed that compared with volume preload, ephedrine maintained maternal blood pressure and uterine artery blood flow. Further, it was associated with lower numbers of hypotension and hypertension episodes and less frequency of bradycardia and tachycardia during cesarean delivery. Conclusion Furthermore, the numbers of boluses of vasopressors used during spinal anesthesia were lower in ephedrine compared with volume preload.