Efficacy and Safety of Prophylactic Ephedrine in Preventing Hypotension during Subarachnoid Block
DOI:
https://doi.org/10.3329/mediscope.v13i1.87098Keywords:
Prophylactic vasoconstrictors, Ephedrine, Subarachnoid block, Hypotension, Hemodynamic stabilityAbstract
Background: Hypotension frequently occurs with subarachnoid block (SAB) due to sympathetic blockade. Ephedrine is used to maintain blood pressure, but requires caution due to possible adverse effects. This study aims to evaluate the efficacy and safety of prophylactic intravenous ephedrine in preventing hypotension in patients undergoing surgery under SAB.
Methods: This prospective, randomized controlled trial was conducted at the Department of Anesthesiology, Gazi Medical College and Hospital, Khulna, Bangladesh. A total of 200 patients undergoing elective surgeries under SAB were randomly assigned to one of two groups using an odd-even method to either the prophylactic Ephedrine Group (n=100) or the Control Group (n=100). Hemodynamic parameters were monitored at multiple intervals. Primary and secondary outcomes included hypotension incidence, additional vasopressor use, and adverse effects. Statistical analyses were performed using SPSS version 26, with p<0.05 considered significant.
Results: Baseline characteristics, including age, BMI, and ASA grade, were comparable between groups. The Ephedrine group demonstrated significantly higher SBP and DBP at 5, 10, and 15 minutes post-SAB (p<0.001). MAP was significantly better maintained in the Ephedrine group at all measured intervals (p<0.001 at 5–15 minutes). The incidence of hypotension was significantly lower in the Ephedrine group (9%) compared to the Control (44%, p<0.001). Fewer patients in the Ephedrine group required additional vasoconstrictors (5% vs. 15%, p=0.021). There was no significant difference in HR or SpO₂ between groups. The Ephedrine group had a shorter mean discharge time (48.6 ± 10.5 vs. 53.2 ± 12.3 min, p=0.038). No significant adverse events related to ephedrine were observed.
Conclusion: Prophylactic ephedrine prevents hypotension during subarachnoid block, ensuring hemodynamic stability with minimal side effects. Patients receiving prophylactic ephedrine required fewer additional vasoconstrictors and had shorter shifting times.
Mediscope 2026;13(1): 34-40
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Copyright (c) 2026 Gaitri Kashyapi, Abhijit Mondol, S. M. Ikbal Kabir, Md. Farhan Azad, Morsheda Yasmin Tamanna
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