Hemodynamics During Cesarean Delivery Under Spinal Anesthesia With Norepinephrine Versus Ephedrine

Echocardiographic Evaluation of Cardiac Output During Cesarean Delivery Under Spinal Anesthesia Using Norepinephrine Versus Ephedrine: A Randomized Controlled Trial

Echocardiography will be used to measure cardiac output and calculate other important hemodynamic variables in healthy patients with full-term singleton pregnancy during cesarean delivery under conventional spinal anesthesia using 2 different vasopressor drugs: norepinephrine in 1 group versus ephedrine in another group.

Inclusion Criteria:

• American Society of Anesthesiologists physical status II.
• Singleton, full term pregnancy.
• Scheduled cesarean delivery under spinal anesthesia.

Exclusion Criteria:

• Height <150 or >180 cm.
• Weight <60 or >110 kg.
• Body mass index (BMI) <18.5 or ≥35 kg/m².
• Women presenting in labor.
• Any contraindication to spinal anesthesia: increased intracranial pressure, coagulopathy, or local skin infection.
• Chronic or pregnancy-induced hypertension.
• Baseline systolic blood pressure >140 mm Hg.
• Hemoglobin <10 g/dl.
• Diabetes mellitus, cardiovascular, cerebrovascular, or renal disease.
• Polyhydramnios or known significant fetal abnormalities.
• Current administration of vasoactive drugs such as: beta blockers, salbutamol, or thyroxin.