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Canadian Journal of Anesthesia, Vol 29, 148-153, Copyright © 1982 by Canadian Anesthesiologists' Society

Prophylactic Intramuscular Ephedrine before Epidural Anaesthesia for Caesarean Section: Efficacy and Actions on the Foetus and Newborn

STEPHEN H. ROLBIN 1, A.F. D. COLE 1, ERNEST M. HEW 2, A. POLLARD 3, and SUSAN VIRGINT 2

1 Obstetrical Anaesthesia; Departments of Anaesthesia and Clinical Biochemistry, Mount Sinai Hospital, and The University of Toronto
2 Departments of Anaesthesia and Clinical Biochemistry, Mount Sinai Hospital, and The University of Toronto
3 Department of Clinical Biochemistry, Departments of Anaesthesia and Clinical Biochemistry, Mount Sinai Hospital, and The University of Toronto

The authors studied the effectiveness of ephedrine given intramuscularly before epidural anaesthesia with bupivacaine 0.5 per cent in three groups of patients undergoing elective caesarean section. The patients received intramuscular saline as a placebo, ephedrine 25 mg or ephedrine 50 mg, 15 to 30 minutes before anaesthesia. The incidence of hypotension was 8 to 12 per cent in all three groups.

Prophylactic intramuscular ephedrine did not lower the incidence of hypotension significantly. Intramuscular ephedrine 50 mg caused a persistent hypertension in eight out of 12 patients and was associated with an increase in umbilical artery [H+] (decrease in pH). No differences were observed in other indices of neonatal well-being. The prophylactic use of intramuscular ephedrine before epidural anaesthesia for caesarean section is not recommended.

Key Words: ANAESTHESIA, obstetrical • ANAESTHETIC TECHNIQUES, epidural • COMPLICATIONS, hypotension, ephedrine prophylaxis




This article has been cited by other articles:


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M. P. Vercauteren, H. C. Coppejans, V. H. Hoffmann, E. Mertens, and H. A. Adriaensen
Prevention of Hypotension by a Single 5-mg Dose of Ephedrine During Small-Dose Spinal Anesthesia in Prehydrated Cesarean Delivery Patients
Anesth. Analg., February 1, 2000; 90(2): 324 - 324.
[Abstract] [Full Text] [PDF]


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Copyright © 1982 by the Canadian Anesthesiologists' Society.