• L Simon, S Provenchère, L de Saint Blanquat, G Boulay, and J Hamza.
• Service d' Anesthésie-Réanimation, Hôpital Saint-Vincent de Paul, Paris, France. mater.anesthesie@svp.ap-hop-paris.fr
• J Clin Anesth. 2001 Aug 1;13(5):366-9.

Study ObjectiveTo compare the incidence of maternal hypotension associated with spinal anesthesia for cesarean section when 10-, 15-, or 20-mg prophylactic boluses of intravenous (IV) ephedrine are used.DesignProspective observational study.SettingTeaching hospital.Patients108 women admitted for elective cesarean section.InterventionsSpinal anesthesia was performed using hyperbaric bupivacaine 10 mg, sufentanil 2 microg, and morphine 0.2 mg (volume 4 mL). Ephedrine (10, 15, or 20 mg) was administered 2 minutes after the intrathecal injection. Maternal blood pressure was checked every 2 minutes. Hypotension was promptly treated with 5-mg ephedrine boluses.Main ResultsIncidence of hypotension was significantly higher in women receiving a 10-mg prophylactic dose of ephedrine than in those receiving either a 15-mg or a 20-mg prophylactic dose of ephedrine [23/36 in the 10-mg ephedrine group vs. 13/36 and 10/36 in the 15-mg and 20-mg ephedrine groups, respectively (p< 0.05)].ConclusionIn the conditions of this study, a single bolus of IV ephedrine with doses of either 15 or 20 mg decreased significantly the incidence of maternal hypotension as compared to a single 10-mg bolus of ephedrine.

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