gynecology and obstetrics medical project, gynecology journal, obstetrics, gynecologic oncology, reproductive medicine, gynecological endoscopy, ultrasonography, gynecology articles

Ginekologia i Poloznictwo
ISSN 1896-3315 e-ISSN 1898-0759

Prevention of hypotention after spinal anesthesia in cesarean section ? A prospective randomized comparative clinical study on ephedrine vs. norepinephrine


Author(s): Sami R. Hasan, Afraa Ibrahim, Talib Razq M and Hayder A. Fawzi*

Background: Ephedrine (EP) and Norepinephrine (NE) considered an option to maintain maternal blood pressure during Spinal Anesthesia (SA) since hypotension is considered a common consequence of SA. The aim of the current study is the assessment of the maternal and neonatal safety and efficacy of NE compared to ephedrine in treatment of SA induced hypotension in cesarian delivery.

Methods: A prospective, randomized comparative clinical study, that involved 100 participants, they were divided into two groups: Group N: received NE (10 μg/ml). Group E: received EP (5 mg/ml). The research was conducted at tertiary Teaching Hospital, and it lasted from February 2021 until October 2022.

Results: Overall, the incidence of hypotension was significantly lower in NE group, and when assessed at various time periods (for 60 minutes), it was significant lower only at 10 minutes. The use of NE was associated with reduction in the risk of hypotension (OR: 0.439) compared to the use of EP.

Conclusion: NE is an effective and safe vasopressor in preventing postanesthetic hypotension in SA for CS devilries, with less hypotensive episodes, better hemodynamic maternal effect, low incidence of nausea, and better neonatal umbilical cord blood gases compared to EP.