The Prophylaxis Effect of Ephedrine on Hemodynamic Variation in Patients Undergoing Percutaneous Nephrolithotomy Surgery with Spinal Anesthesia

Background. Performing spinal anesthesia with at least hemodynamic variation and complications is always challenging for anesthesiologists. In this study, we investigated the effect of ephedrine and placebo on hemodynamic changes in patients undergoing percutaneous nephrolithotomy with spinal anesth...

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Main Authors: Shahryar Sane, Ali Akbar Nasiri, Ayatay Bahrami, Zaynitdin Kamalov, Shadia Hamoud Alshahrani, Hadi Sajid Abdulabbas, Shahram Darvishzadehdaledari, Parang Golabi, Behzad Kazemi Haki
Format: Article
Language:English
Published: Wiley 2023-01-01
Series:International Journal of Clinical Practice
Online Access:http://dx.doi.org/10.1155/2023/8966501
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author Shahryar Sane
Ali Akbar Nasiri
Ayatay Bahrami
Zaynitdin Kamalov
Shadia Hamoud Alshahrani
Hadi Sajid Abdulabbas
Shahram Darvishzadehdaledari
Parang Golabi
Behzad Kazemi Haki
author_facet Shahryar Sane
Ali Akbar Nasiri
Ayatay Bahrami
Zaynitdin Kamalov
Shadia Hamoud Alshahrani
Hadi Sajid Abdulabbas
Shahram Darvishzadehdaledari
Parang Golabi
Behzad Kazemi Haki
author_sort Shahryar Sane
collection DOAJ
description Background. Performing spinal anesthesia with at least hemodynamic variation and complications is always challenging for anesthesiologists. In this study, we investigated the effect of ephedrine and placebo on hemodynamic changes in patients undergoing percutaneous nephrolithotomy with spinal anesthesia. Methods. This randomized, double-blind prospective clinical trial was conducted on 120 patients aged 20‒60 years with ASA (American Society of Anesthesiologists) classes I and II. Patients who were candidates for percutaneous nephrolithotomy with spinal anesthesia were divided into intervention (received 1 cc = 5 mg ephedrine) and control groups (received 1 cc normal saline). All vital parameters, including HR (heart rate) and NIBP (noninvasive blood pressure), were recorded perioperatively T0–T25) and finally at the end of surgery time (Tf). The results were analyzed by SPSS software version 23, and a P value ≤0.05 was considered significant. Results. The mean arterial pressure during surgery between T3 and T9 and the mean heart rate in times of T3–T8 in the intervention group were higher than in the control group, and this difference was statistically significant (P<0.05). The incidence of hypotension, bradycardia, nausea, and vomiting and the amount of prescribed ephedrine, atropine, and ondansetron in the control group were higher than in the intervention group (P=0.001). Seven patients in the control group and four in the intervention group had shivering, but this difference was not statistically significant (P=0.43). Conclusion. This study showed the effectiveness of the prescription of 5 mg ephedrine two minutes before changing from the lithotomy position to the supine in maintaining hemodynamic stability, reducing hypotension, bradycardia, nausea, and vomiting, and the amount of prescribed ephedrine, atropine, and ondansetron. Trial Registrations. This trial is registered with IRCT20160430027677N22.
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spelling doaj-art-721de5824a4e4e31b4d577d4e3d4aab22025-08-20T03:33:42ZengWileyInternational Journal of Clinical Practice1742-12412023-01-01202310.1155/2023/8966501The Prophylaxis Effect of Ephedrine on Hemodynamic Variation in Patients Undergoing Percutaneous Nephrolithotomy Surgery with Spinal AnesthesiaShahryar Sane0Ali Akbar Nasiri1Ayatay Bahrami2Zaynitdin Kamalov3Shadia Hamoud Alshahrani4Hadi Sajid Abdulabbas5Shahram Darvishzadehdaledari6Parang Golabi7Behzad Kazemi Haki8Department of AnesthesiologyDepartment of AnesthesiologyDepartment of MedicineDepartment of ImmunoregulationMedical Surgical Nursing DepartmentContinuous Education DepartmentDepartment of Health SciencesDepartment of AnesthesiologyDepartment of AnesthesiologyBackground. Performing spinal anesthesia with at least hemodynamic variation and complications is always challenging for anesthesiologists. In this study, we investigated the effect of ephedrine and placebo on hemodynamic changes in patients undergoing percutaneous nephrolithotomy with spinal anesthesia. Methods. This randomized, double-blind prospective clinical trial was conducted on 120 patients aged 20‒60 years with ASA (American Society of Anesthesiologists) classes I and II. Patients who were candidates for percutaneous nephrolithotomy with spinal anesthesia were divided into intervention (received 1 cc = 5 mg ephedrine) and control groups (received 1 cc normal saline). All vital parameters, including HR (heart rate) and NIBP (noninvasive blood pressure), were recorded perioperatively T0–T25) and finally at the end of surgery time (Tf). The results were analyzed by SPSS software version 23, and a P value ≤0.05 was considered significant. Results. The mean arterial pressure during surgery between T3 and T9 and the mean heart rate in times of T3–T8 in the intervention group were higher than in the control group, and this difference was statistically significant (P<0.05). The incidence of hypotension, bradycardia, nausea, and vomiting and the amount of prescribed ephedrine, atropine, and ondansetron in the control group were higher than in the intervention group (P=0.001). Seven patients in the control group and four in the intervention group had shivering, but this difference was not statistically significant (P=0.43). Conclusion. This study showed the effectiveness of the prescription of 5 mg ephedrine two minutes before changing from the lithotomy position to the supine in maintaining hemodynamic stability, reducing hypotension, bradycardia, nausea, and vomiting, and the amount of prescribed ephedrine, atropine, and ondansetron. Trial Registrations. This trial is registered with IRCT20160430027677N22.http://dx.doi.org/10.1155/2023/8966501
spellingShingle Shahryar Sane
Ali Akbar Nasiri
Ayatay Bahrami
Zaynitdin Kamalov
Shadia Hamoud Alshahrani
Hadi Sajid Abdulabbas
Shahram Darvishzadehdaledari
Parang Golabi
Behzad Kazemi Haki
The Prophylaxis Effect of Ephedrine on Hemodynamic Variation in Patients Undergoing Percutaneous Nephrolithotomy Surgery with Spinal Anesthesia
International Journal of Clinical Practice
title The Prophylaxis Effect of Ephedrine on Hemodynamic Variation in Patients Undergoing Percutaneous Nephrolithotomy Surgery with Spinal Anesthesia
title_full The Prophylaxis Effect of Ephedrine on Hemodynamic Variation in Patients Undergoing Percutaneous Nephrolithotomy Surgery with Spinal Anesthesia
title_fullStr The Prophylaxis Effect of Ephedrine on Hemodynamic Variation in Patients Undergoing Percutaneous Nephrolithotomy Surgery with Spinal Anesthesia
title_full_unstemmed The Prophylaxis Effect of Ephedrine on Hemodynamic Variation in Patients Undergoing Percutaneous Nephrolithotomy Surgery with Spinal Anesthesia
title_short The Prophylaxis Effect of Ephedrine on Hemodynamic Variation in Patients Undergoing Percutaneous Nephrolithotomy Surgery with Spinal Anesthesia
title_sort prophylaxis effect of ephedrine on hemodynamic variation in patients undergoing percutaneous nephrolithotomy surgery with spinal anesthesia
url http://dx.doi.org/10.1155/2023/8966501
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