Comparative study between pre-emptive intramuscular ephedrine and intravenous ephedrine to prevent hypotension during spinal anaesthesia in caesarean section

Introduction: There is a considerable dispute over use of different techniques for prevention of hypotension during caesarean section.Spinal Anesthesia induced hypotension in obstetric patients is still a challenge for many anaesthesiologists as it may lead to complications like reduced utero-placental blood flow leading to fetal acidosis.Aims: The aim of the present study is to compare the effects and side effects of ephedrine administered via two different routes, that is intravenous and intramuscular route.Methods and materials: Institutional Ethics Committee approval was taken before the commencement of the study.An informed and written consent was taken from every patient selected for the study.A randomized study was done on 60 parturient aged between 20-30years, divided into Group IM (n=30) where intramuscular ephedrine 30 mg given 10 min prior to spinal anaesthesia and Group IV (n=30) where intravenous ephedrine 12 mg given at the time of spinal anaesthesia.After intravenous preloading(10-15 ml/kg), spinal anaesthesia was given, baseline maternal heart rate and arterial blood pressure were recorded before induction and every 2 min for first 10 min and thereafter every 5 min for 45 min.Results: Mean age of patients in group IM and Group IV was 23.03±2.37 and 24.47±2.25 years respectively (p>0.05).In the intramuscular group, the fall in mean blood pressure after spinal anesthesia was hardly about 10% of the preoperative blood pressure.In the intravenous group, there was a fall in the blood pressure after spinal anesthesia for a short period of time which was statistically significant (p<0.05).Conclusion: Prophylactic use of intramuscular ephedrine in parturient prevents hypotension when compared to intravenous ephedrine during caesarean section.