The influence of the infusion of ephedrine and phenylephrine on the hemodynamic stability after subarachnoid anesthesia in senior adults - a controlled randomized trial
Abstract Background We studied the influence of ephedrine or phenylephrine infusion administered immediately after spinal anesthesia (SA) on hemodynamics in elderly orthopedic patients. Methods A prospective, randomized, double-blind, placebo-controlled study. After a subarachnoid injection of 15 mg...
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| Format: | Article |
| Language: | English |
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BMC
2019-11-01
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| Series: | BMC Anesthesiology |
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| Online Access: | http://link.springer.com/article/10.1186/s12871-019-0878-4 |
| _version_ | 1818456094925651968 |
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| author | Miodrag Žunić Nevenka Krčevski Škvarč Mirt Kamenik |
| author_facet | Miodrag Žunić Nevenka Krčevski Škvarč Mirt Kamenik |
| author_sort | Miodrag Žunić |
| collection | DOAJ |
| description | Abstract Background We studied the influence of ephedrine or phenylephrine infusion administered immediately after spinal anesthesia (SA) on hemodynamics in elderly orthopedic patients. Methods A prospective, randomized, double-blind, placebo-controlled study. After a subarachnoid injection of 15 mg of levobupivacaine, the participants received an infusion of either ephedrine 20 mg (E group), phenylephrine 250 mcg (P group) or saline (C group) within 30 min. We measured blood pressure, cardiac index (CI) and heart rate (HR) from 15 min before to 30 min after SA. Results Seventy patients were included in the final analysis. At the end of measurements, mean arterial pressure (MAP) decreased significantly after SA in comparison to the baseline value in the C group but was maintained in the P and E group, with no significant differences between the groups. CI decreased after SA in the C group, was maintained in the P group, and increased significantly in the E group with significant differences between the C and E group (p = 0.049) also between the P and E (p = 0.01) group at the end of measurements. HR decreased significantly after SA in the C and P group but was maintained in the E group, with significant differences between the P and E group (p = 0.033) at the end of measurements. Conclusions Hemodynamic changes after SA in elderly orthopedic patients can be prevented by an immediate infusion of phenylephrine or ephedrine. In addition to maintaining blood pressure, the ephedrine infusion also maintains HR and increases CI after SA. Trial registration ISRCTN registry with registration number ISRCTN44377602, retrospectively registered on 15 June 2017. |
| first_indexed | 2024-12-14T22:21:13Z |
| format | Article |
| id | doaj.art-b07fb47dc58642659c19cd679a0d7cda |
| institution | Directory Open Access Journal |
| issn | 1471-2253 |
| language | English |
| last_indexed | 2024-12-14T22:21:13Z |
| publishDate | 2019-11-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Anesthesiology |
| spelling | doaj.art-b07fb47dc58642659c19cd679a0d7cda2022-12-21T22:45:29ZengBMCBMC Anesthesiology1471-22532019-11-011911810.1186/s12871-019-0878-4The influence of the infusion of ephedrine and phenylephrine on the hemodynamic stability after subarachnoid anesthesia in senior adults - a controlled randomized trialMiodrag Žunić0Nevenka Krčevski Škvarč1Mirt Kamenik2Department of Anesthesiology, Intensive Care and Pain Management, University Medical Center MariborDepartment of Anesthesiology, Intensive Care and Pain Management, University Medical Center MariborDepartment of Anesthesiology, Intensive Care and Pain Management, University Medical Center MariborAbstract Background We studied the influence of ephedrine or phenylephrine infusion administered immediately after spinal anesthesia (SA) on hemodynamics in elderly orthopedic patients. Methods A prospective, randomized, double-blind, placebo-controlled study. After a subarachnoid injection of 15 mg of levobupivacaine, the participants received an infusion of either ephedrine 20 mg (E group), phenylephrine 250 mcg (P group) or saline (C group) within 30 min. We measured blood pressure, cardiac index (CI) and heart rate (HR) from 15 min before to 30 min after SA. Results Seventy patients were included in the final analysis. At the end of measurements, mean arterial pressure (MAP) decreased significantly after SA in comparison to the baseline value in the C group but was maintained in the P and E group, with no significant differences between the groups. CI decreased after SA in the C group, was maintained in the P group, and increased significantly in the E group with significant differences between the C and E group (p = 0.049) also between the P and E (p = 0.01) group at the end of measurements. HR decreased significantly after SA in the C and P group but was maintained in the E group, with significant differences between the P and E group (p = 0.033) at the end of measurements. Conclusions Hemodynamic changes after SA in elderly orthopedic patients can be prevented by an immediate infusion of phenylephrine or ephedrine. In addition to maintaining blood pressure, the ephedrine infusion also maintains HR and increases CI after SA. Trial registration ISRCTN registry with registration number ISRCTN44377602, retrospectively registered on 15 June 2017.http://link.springer.com/article/10.1186/s12871-019-0878-4Spinal anesthesiaHemodynamic stabilityPhenylephrineEphedrine |
| spellingShingle | Miodrag Žunić Nevenka Krčevski Škvarč Mirt Kamenik The influence of the infusion of ephedrine and phenylephrine on the hemodynamic stability after subarachnoid anesthesia in senior adults - a controlled randomized trial BMC Anesthesiology Spinal anesthesia Hemodynamic stability Phenylephrine Ephedrine |
| title | The influence of the infusion of ephedrine and phenylephrine on the hemodynamic stability after subarachnoid anesthesia in senior adults - a controlled randomized trial |
| title_full | The influence of the infusion of ephedrine and phenylephrine on the hemodynamic stability after subarachnoid anesthesia in senior adults - a controlled randomized trial |
| title_fullStr | The influence of the infusion of ephedrine and phenylephrine on the hemodynamic stability after subarachnoid anesthesia in senior adults - a controlled randomized trial |
| title_full_unstemmed | The influence of the infusion of ephedrine and phenylephrine on the hemodynamic stability after subarachnoid anesthesia in senior adults - a controlled randomized trial |
| title_short | The influence of the infusion of ephedrine and phenylephrine on the hemodynamic stability after subarachnoid anesthesia in senior adults - a controlled randomized trial |
| title_sort | influence of the infusion of ephedrine and phenylephrine on the hemodynamic stability after subarachnoid anesthesia in senior adults a controlled randomized trial |
| topic | Spinal anesthesia Hemodynamic stability Phenylephrine Ephedrine |
| url | http://link.springer.com/article/10.1186/s12871-019-0878-4 |
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