[Ephedrine and etilefrine as vasopressor to correct maternal arterial hypotension during elective cesarean section under spinal anesthesia. Comparative study]

Abstract

Background and objectives: Ephedrine is the most popular vasopressor for obstetrics and etilefrine is widely used in regional anesthesia. This study aimed at comparing ephedrine and etilefrine to correct maternal arterial hypotension during elective Cesarean section under spinal anesthesia.

Methods: Participated in this study 120 pregnant patients who were randomly distributed in two equal groups. All patients received spinal anesthesia with bupivacaine, fentanyl and morphine. Noninvasive blood pressure and heart rate were monitored. Neonates were evaluated by the Apgar score. The incidence of hypotension, the amount of vasopressor needed to correct it and adverse effects were recorded.

Results: Maternal hypotension was similar in both groups (68% etilefrine group and 63% ephedrine group). The first vasopressor dose was enough to correct hypotension in most patients, with no difference between groups (66% etilefrine, 58% ephedrine). Few patients needed two or more doses to correct hypotension or presented reactive hypertension (24% and 10% in etilefrine and 34% and 8% in ephedrine groups, respectively), without statistically significant differences. There were no differences in adverse effects and neonate tests.

Conclusions: With the administration method and selected vasopressor doses, there have been no differences between ephedrine and etilefrine used to correct maternal hypotension during Cesarean section under spinal anesthesia.