Vol. 7, Issue 1, Part A (2025)

Background: Spinal anaesthesia is often used for planned caesarean sections, but it can sometimes cause low blood pressure, which may negatively affect both the mother and the baby.

Aims of the study: Evaluate the effectiveness of prophylactic ephedrine in preventing post-spinal hypotension in women undergoing elective cesarean section and to assess its impact on maternal and fetal outcomes.

Methodology: This prospective study, conducted at Al-Imam Ali General Hospital, Baghdad (February 2-April 20, 2021), included 60 patients divided into two groups: prophylactic (6 mg ephedrine) and non-prophylactic during spinal anesthesia. Exclusions included anesthesia refusal, hypertension, chronic diseases, or fetal anomalies. Spinal anesthesia used 0.5% bupivacaine, with preoperative evaluation, fasting, medications, and comprehensive hemodynamic monitoring.

Results: The study revealed significant differences in hemodynamic parameters between patients receiving prophylactic ephedrine and those who did not during spinal anesthesia. The prophylactic group showed reduced cardiac arrhythmias (63.5 ± 11.383 vs. 54.83 ± 10.212), improved heart rate (HR), and higher systolic pressure (SYS) across all intervals. Statistical analysis confirmed significant changes in cardiac arrhythmias and systolic pressure (P<0.01), highlighting ephedrine’s role in enhancing hemodynamic stability. However, heart rate changes were statistically significant only after 15 minutes (p<0.05).

Conclusion: The study concludes that prophylactic ephedrine effectively reduces cardiac arrhythmias and maintains systolic blood pressure during spinal anesthesia, enhancing hemodynamic stability. This is likely due to ephedrine’s vasoconstrictive and sympathomimetic effects, which counteract anesthesia-induced vasodilation and hypotension. Its limited impact on heart rate suggests a targeted mechanism improving overall surgical outcomes.