Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2017 May 29:6:60.
doi: 10.4103/2277-9175.207147. eCollection 2017.

A Comparison of Intravenous Ephedrine or Phenylephrine, for Prevention of Postspinal Hypotension during Elective Lower Abdominal Surgery: A Randomized, Double-blind Case-control Study

Khosrou Naghibi  1 , Mojtaba Rahimi  1 , Zahra Mashayekhi  2
Affiliations

A Comparison of Intravenous Ephedrine or Phenylephrine, for Prevention of Postspinal Hypotension during Elective Lower Abdominal Surgery: A Randomized, Double-blind Case-control Study

Khosrou Naghibi et al. Adv Biomed Res. .

Abstract

Background: In this randomized, double-blinded case-control study, we investigated the intravenous effects of ephedrine or phenylephrine on prevention of post-spinal hypotension in elective lower abdominal surgery under spinal anesthesia.

Materials and methods: One hundred and thirty-five patients, American Society of Anesthesiologists physical status I or II candidate for elective lower abdominal surgery under spinal anesthesia were randomized to three groups (45 each). According to their allocated group, patients received either ephedrine 2.5 mg (E group), phenylephrine (P group) 25 mic as vasopressor or the same volume of saline normal as placebo (S group) immediately after the spinal anesthesia. hemodynamic parameters, and complications were recorded.

Results: Patients' demographics were similar in all the groups. The mean systolic blood pressure (SBP), diastolic blood pressure (DBP), and MAP and also heart rate were similar over time for groups E and P (P > 0.05). The incidence of reactive hypertension was more in group E than group P and placebo (P < 0.05). The incidence of nausea and vomiting were significantly lower in groups E and P in comparison with placebo (P < 0.05).

Conclusion: Although the mean fall of SBP and DBP were significantly less in groups E and P compared with placebo but we did not find significant differences in prophylactic use of ephedrine or phenylephrine for prevention of post-spinal hypotension in elective lower abdominal surgery. Vasopressors infusion have added benefit of lower incidence of nausea and vomiting.

Keywords: Elective lower abdominal surgery; ephedrine; phenylephrinr; postspinal hypotension.

PubMed Disclaimer

Conflict of interest statement

There are no conflicts of interest.

Figures

Figure 1
Figure 1
The flowchart of randomized patients
Figure 2
Figure 2
The trend of SBP, DBP, MAP, and HR are shown during the intervention between three groups. SBP (systolic blood pressure), DBP (diastolic blood pressure), MAP, HR (heart rate)
See this image and copyright information in PMC

References

    1. Das S, Mukhopadhyay S, Mandal M, Mandal S, Basu SR. A comparative study of infusions of phenylephrine, ephedrine and phenylephrine plus ephedrine on maternal haemodynamics in elective caesarean section. Indian J Anaesth. 2011;55:578–83. - PMC - PubMed
    1. Saravanan S, Kocarev M, Wilson RC, Watkins E, Columb MO, Lyons G. Equivalent dose of ephedrine and phenylephrine in the prevention of post-spinal hypotension in Caesarean section. Br J Anaesth. 2006;96:95–9. - PubMed
    1. Stewart A, Fernando R, McDonald S, Hignett R, Jones T, Columb M. The dose-dependent effects of phenylephrine for elective cesarean delivery under spinal anesthesia. Anesth Analg. 2010;111:1230–7. - PubMed
    1. Ansari T, Hashem MM, Hassan AA, Gamassy A, Saleh A. Comparison between two phenylephrine infusion rates with moderate co-loading for the prevention of spinal anaeshtesia-induced hypotension during elective caesarean section. Middle East J Anesthesiol. 2011;21:361–6. - PubMed
    1. Loubert C. Fluid and vasopressor management for Cesarean delivery under spinal anesthesia: Continuing professional development. Can J Anaesth. 2012;59:604–19. - PubMed