Safety and efficacy of prophylactic ephdrine in preventing hypotension following spinal anesthesia in parturients undergoing caesarean section at Mulago Hospital

Abstract

Hypotension following spinal anesthesia is a wee recognized complication, in the parturient undergoing caesarean section, which poses a great threat to the well being being of both the mother and foetus. The prevalence of hypotension following spinal anesthesia for parturients undergoin caesarean section in mulago hospital is very high (72%). This study was done to determine the incidence of hypotension, the safety and efficacy of intravenous ephedrine in preventing hypotension following spinal anesthesia in partrieunts undergoing caesarean section at mulago hospital. It was a randomized controlled clinical trial recruiting total of 980 patents comprising 40 patients in each study group. The study was conducted in obstetric theatres in the 5th floor. Conscent of the recruited patients was obtained, rndomised, baseline pulse and blood pressure were recorded, preloaded with 1 litre of normal saline. The partirients were administered the study drug (ephedrine/placebo) and then subjected to spinal anesthesia. Pulse and blood pressure were recorded every five minutes from the time of induction of spinal anaesthesia until the recovery. Data was collected using pre-coded questionnaires, cleaned and entered usi ng EPIDATA 6.04 and analyzed using SPSS 10.0 software. The results of this study showed that hypotension was found in both the study groups with the incidence however, significantly much higher in the placebo group than the Ephedrine group (p value 0.04). Out of 40 patients in the ephedrine group 15 of them (37.5%) developed hypotension, compared with 24 (60%) out of 40 in the placebo group. The study has shown that prophylactic intravenous ephedrine is beneficial in the prevention of hypotension following spinal anesthesia. Hence the use of prophylactic intravenous ephedrine 20mg is recommended in all patients who undergo caesarean section under spinal anesthesia in mulago hospital.