ISSN 0975-3583
 

Journal of Cardiovascular Disease Research



    To Compare the Effectiveness of Prophylactic Intramuscular Bolus Dose And Intermittent Intravenous Doses Of Injection Ephedrine On Subarachnoid Block Induced Hypotension


    Dr. Ritesh Dixit Dr. Arushi Dua Dr. Deepak Joshi
    JCDR. 2023: 756-772

    Abstract

    Subarachnoid block is a preferred mode of anesthesia for various lower abdominal, pelvic and lower limb orthopedic surgeries owing to its multiple advantages. However, it is not devoid of complications like hypotension and bradycardia. These hemodynamic complications result in significant morbidity and mortality. One of the ways to overcome hypotension is use of vasopressors, out of which Ephedrine is most commonly used vasopressor over the years. Dilemma exists on the better mode of administration. In this observational study, we compared the effectiveness of 30 mg prophylactic intramuscular ephedrine given 15 minutes before giving subarachnoid block with 6 mg intermittent intravenous doses given for treating subarachnoid block induced hypotension and side effects associated with both during routine surgeries performed under subarachnoid block. Results- Hemodynamic monitoring was done vital parameters (NIBP, PR, Spo2) were corelated with amount and duration of Injection Ephedrine administration. There was significant rise in Blood pressure and pulse rate after 15 minutes in patients who received prophylactic 30 mg Injection Ephedrine intramuscularly. Although, after giving subarachnoid block, both groups experienced a fall in average blood pressures, maximum fall being at 3 minutes and 5 minutes after administration, the fall was significantly higher in patients who did not receive the prophylactic bolus dose. These patients were supplemented with intravenous 6 mg doses of Injection Ephedrine whenever mean arterial pressure dropped below 20% of baseline values. 19 patients (59.38 %) developed clinically significant hypotension at 5 minutes after giving SAB and required 6 mg injection Ephedrine administration followed by 10 patients (31.25%) at 3 minutes after SAB, 6 patients (18.75%) at 10 minutes and 20 minutes after SAB and so on. Also, 15 patients required only 1 dose (6 mg) Injection ephedrine administration, 15 patients required 2 doses (12mg), 1 patient required 3 doses(18 mg) and 1 patient required 4 doses(24 mg) injection Ephedrine over the course of surgery.

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    Volume & Issue

    Volume 14 Issue 4

    Keywords