Comparison of the effectiveness of ephedrine and noradrenaline in the treatment of hypotension due to spinal anesthesia in caesarea section surgery

Aim: In this prospective study, we aimed to compare the maternal hemodynamic effects, side effects and neonatal outcomes of ephedrine or noradrenaline use in pregnant women who underwent cesarean section with spinal anesthesia. Materials and Methods: In this study, 70 healthy pregnant women who underwent cesarean section under spinal anesthesia were randomized into two groups: group E and group N. Immediately after intrathecal local anesthetic administration, an IV bolus of 10 mg ephedrine was administered as a prophylactic vasopressor to Group E and an additional 5 mg bolus of ephedrine in the presence of hypotension. A prophylactic IV bolus of 8 mcg noradrenaline and an additional 8 mcg noradrenaline bolus was administered to Group N. Results: The incidence of hypotension was found to be lower group E than group N (p = 0.033). Group N, systolic arterial pressure values measured at the 9th minute after spinal anesthesia (p=0.008) and after birth were lower. There is no significant difference in tachycardia, bradycardia, and atropine requirement between the two groups. Heart rates were found to be lower Group N at the 6th minute (p=0.049) and the 9th minute (p=0.031). Conclusion: In preventing hypotension due to spinal anesthesia in cesarean section surgeries, prophylactic 8 mcg noradrenaline, 8 mcg bolus administration resulted in a higher incidence of hypotension compared to the prophylactic 10 mg ephedrine, 5mg bolus administration group. More studies are needed regarding different noradrenaline doses and infusion application in the prevention of hypotension. Keywords: Hemodynamics, cesarean section, vasopressor, spinal anesthesia