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首页> 外文期刊>Clinical Practice >Administration of Ephedrine versus Norepinephrine for Management of Post-Spinal Hypotension during Lower Limb Orthopedic Surgery
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Administration of Ephedrine versus Norepinephrine for Management of Post-Spinal Hypotension during Lower Limb Orthopedic Surgery

机译：麻黄碱和去甲肾上腺素在下肢整形外科手术中的脊髓后低血压管理

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Background: Neuraxial anaesthesia technique induce vasodilation, this may result in hypotension requiring the administration of vasopressors drugs. The present study was conducted to compare the effects of intermittent I.V. boluses of ephedrine (EPH) and norepinephrine (NE) on maintain arterial blood pressure in patients undergoing lower limb orthopedic surgery during spinal. Aim: To compare the efficacy and safety of intermittent boluses administration of ephedrine (EPH) versus norepinephrine (NE) for treatment of hypotension patients during spinal anesthesia for patients undergoing lower limb orthopedic surgery. Patients and methods: A randomized, double-blinded study was carried out on 100 patients ASA I or II undergoing lower limb orthopedic surgery. The patients were divided into two groups of 50 patients, the ephedrine group (EPH group): received 5 mg intravenously bolus (IV) and the norepinephrine group (NE group): received 5μg intravenously bolus (IV) when hypotension occurred (systolic blood pressure decrease by 20% or more from baseline). Systolic blood pressure (SBP), mean arterial blood pressure (MAP) and heart rate (HR) were recorded at baseline (before spinal anasethesia) and after initiation of spinal anaesthesia at 3, 6, 9, 12, 15 minutes then every 5mins were measured for 30 mins then every 15 minutes up to end of surgery. The number of boluses of vasopressors, incidence of bradycardia, tachycardia and hypertension episodes were recorded. Also incidence of side effects during surgery were recorded. Results: There was no significant difference in SBP and MAP between both groups in all times P <0.05 however, the rise in heart rates were significant higher in group EPH than group NA at 6, 9, 12 mins (p <0.001) but bradycardia was not significantly different between the two groups P <0.05. The number of boluses of vasopressors required to maintain systolic blood pressure were lower in NE group 29/ 45 patients (64.4%) than EPH group 24/ 45 patients (53.3%). The incidence of hypertension and bradycardia were not significantly different between the two groups however tachycardia were significantly higher (P < 0.01) in group EPH. There was no significant difference in side effects during surgery between both groups. Conclusions: Norepinephrine is potent drug can be used as an alternative vasopressor for maintainance of blood pressure during post-spinal hypotension.
机译：背景：神经麻醉技术会引起血管舒张，这可能导致低血压，需要使用血管加压药。进行本研究以比较间歇性I.V.麻黄碱（EPH）和去甲肾上腺素（NE）的大剂量可维持脊柱下肢骨科手术患者的动脉血压。目的：比较麻痹性麻黄素（EPH）和去甲肾上腺素（NE）间歇性大剂量给药治疗在下肢骨科手术患者脊髓麻醉期间低血压患者的疗效和安全性。患者和方法：对100例接受下肢骨科手术的ASA I或II患者进行了一项随机双盲研究。将患者分为两组，每组50例，麻黄碱组（EPH组）：接受5 mg静脉推注（IV）和去甲肾上腺素组（NE组）：在发生低血压（收缩压）时接受5μg静脉推注（IV）比基准降低20％或更多）。在基线（脊髓麻醉前）和开始麻醉3、6、9、12、15分钟后每5分钟记录收缩压（SBP），平均动脉压（MAP）和心率（HR）。测量30分钟，然后每15分钟测量一次，直到手术结束。记录血管加压药的剂量，心动过缓，心动过速和高血压发作的发生率。还记录了手术期间的副作用发生率。结果：两组之间的SBP和MAP在所有时间均无显着性差异 P <0.05，但是，在6、9、12分钟时，EPH组的心率升高明显高于NA组（p <0.001 ），但两组的心动过缓没有显着差异（P <0.05）。 NE组29/45例患者（64.4％）比维持EPH组24/45例（53.3％）低，维持维持收缩压所需的升压药的数量较少。两组之间高血压和心动过缓的发生率无显着差异，但EPH组心动过速显着较高（P <0.01）。两组之间在手术期间的副作用没有显着差异。结论：去甲肾上腺素是一种有效的药物，可替代脊柱降压期间维持血压的升压药。

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