Comparison of the effect of intravenous epinephrine and ephedrine in the management of hypotension and bradycardia during cesarean section under spinal anesthesia in Kamali Hospital, Karaj

Introduction: hypotension and bradycardia are two underlying and almost common complications caused by spinal anesthesia in cases of elective cesarean section (CS). Suitable treatment of the complications is particularly important to improve the conditions of patients. Hence, the aim of this study is to compare the effect of intravenous administration of epinephrine and ephedrine in the management of hypotension and bradycardia caused by CS spinal anesthesia. Method: the study was done as a random clinical trial on 126 women under spinal anesthesia for elective CS, hospitalized in Kamali Hospital, Karaj in 2020-21. The statistical samples were classified into two ephedrine and epinephrine. Patients systolic blood pressure, diastolic blood pressure, heart rate and Apgar and VBG of the newborn were analyzed in two study groups. Results: The results showed that the mean value of diastolic blood pressure, which was the same in the two groups at the beginning, was significantly increased in the ephedrine group compared to the epinephrine group from minute eight. Mean systolic blood pressure, which was the same in the two groups at the beginning, was significantly increased in the ephedrine group compared to the epinephrine group in minutes 8-16. However, they showed no significant difference in the rest of the evaluations. The mean value of heart rate that was the same between the two groups at the beginning was significantly increased in the ephedrine group in minutes 10, 25, 35, and 45; although the two groups showed no significant difference in other times assessed. The mean value of PCO 2 and HCO 3 showed a significant difference between the two groups, and both were higher in the ephedrine group. Conclusion: Our results indicate that intravenous ephedrine compared to intravenous epinephrine produces a higher increasing the values blood pressure and heart rate in the management of hypotension and bradycardia caused by spinal anesthesia in the cases of elective cesarean section.