Ephedrine Doses to Prevent Maternal Hypotension After Spinal Anesthesia in Cesarean Section

A Randomized Controlled Trial Comparing the Effectiveness of Different Doses of Ephedrine Infusion in Preventing Maternal Hypotension Following Spinal Anesthesia for Caesarean Section

This randomized controlled trial aims to compare the effectiveness of different doses of ephedrine infusion in preventing maternal hypotension following spinal anesthesia in parturients undergoing cesarean sections. The study includes 120 participants, aged 18-40 years, with American Society of Anesthesiologists (ASA) physical status II, who are scheduled for elective cesarean delivery. The primary objective is to determine whether low-dose ephedrine infusions at 1.25 mg/min or 1.5 mg/min effectively reduce the incidence of maternal hypotension, with secondary outcomes assessing the need for rescue ephedrine, incidence of side effects (nausea, vomiting, tachycardia), and neonatal Apgar scores. Researchers will compare three groups-saline, 1.25 mg/min ephedrine, and 1.5 mg/min ephedrine-to evaluate their impact on maternal hemodynamic stability.

Inclusion Criteria:

• Patients undergoing cesarean section
• Self-identified as female
• American Society of Anesthesiologists (ASA) physical status II
• Aged between 18 to 40 years
• Full-term singleton pregnancies planned for cesarean delivery under spinal anesthesia

Exclusion Criteria:

• Body mass index (BMI) ≥ 40 kg/m²
• Height less than 145 cm
• Presence of severe neurological or psychiatric conditions
• History of pre-eclampsia
• Severe renal or metabolic disorders
• Contraindications to spinal anesthesia
• Antenatal evidence of fetal anomalies
• Cases with severely compromised fetuses requiring immediate general anesthesia
• Baseline systolic blood pressure (SBP) less than 90 mm Hg
• Pregnancy-induced hypertension
• Refusal to provide written consent