Effect of Prophylactic Ephedrine Infusion versus Crystalloid Preloading on Neonatal Acid-Base Outcome during Spinal Anesthesia for Elective Caesarean Section

Background: Regional anaesthesia has become the preferred technique for caesarean section because general anaesthesia is associated with higher incidence of maternal morbidity and mortality. Ephedrine is the drug of choice to treat spinal-induced hypotension in caesarean patients, but a clinically relevant positive effect on neonatal outcome were not observed in some studies done in the past. So in our study we compared the effect of pretreatment with crystalloid versus ephedrine infusion in neonates during spinal anesthesia for caesarean delivery. Objectives: To assess the safety of prophylactic ephedrine infusion versus crystalloid preloading in neonates. Methodology: 60 subjects were randomly categorized into two groups of 30 each Group I (Crystalloid group) preloaded with 15 ml/kg of Ringer lactate and Group II (Ephedrine group) infusion of 30 mg ephedrine in 500 ml Ringer lactate at a rate of 2 drops/sec was started 5 min before administering spinal anaesthesia. The safety was compared in terms of APGAR score and umbilical cord blood gases in the neonatal outcome. Results: The APGAR score at 1 min and 5 min were good in both the groups. There were no incidence of fetal acidosis. There were no significant (p > 0.05) difference in the umbilical blood gas values between Group I and Group II. Conclusion: The study concludes that prophylactic low dose of ephedrine infusion does not cause adverse neonatal outcome.