Small dose of ephedrine for prevention of hypotension following propofol and fentanyl administration during induction of general anesthesia

Abstract

Induction of general anesthesia with propofol and fentanyl could result in hypotension and bradycardia. Various methods are being used to prevent these adverse effects. The aim of our study was to assess the efficacy and safety of a small dose of ephedrine in prevention of hypotension following administration of propofol and fentanyl. This prospective, randomized, comparative study was conducted among a total of 50 patients, both genders, age 18 years up to 60 years with ASA grade Ι and ΙΙ and some of class ΙΙΙ, presented for elective surgery under general anesthesia. Patients were randomly allocated into one of two groups (25 patients in each): CG (the control group), which received propofol in a dose of 2 mg/kg, intravenously, over 20–30 s mixed with 2 mL normal saline: and EphG (Ephedrine group), while received propofol in a dose of 2 mg/kg, intravenously, over 20–30 s mixed with 2 mL of ephedrine (10 mg). The Mean Arterial Blood Pressure (MAP) and Heart Rate (HR) were recorded before induction and then every 1 min up to 6 min after induction. The categorical data are presented as a number and percentage and were subjected to Fisher’s exact or Chi-square test for analysis. The statistical significance was p≤0.05. The significant differences in HR were observed in the 3rd,4th, and 5th minutes with P-value, 0.018, 0.000, 0.000, respectively. However, no patient in the study participants had bradycardia. The significant differences in MAP were observed in the 2nd, 3rd,4th, and 5th minutes with P-value, 0.035, 0.000, 0.000, and 0.000, respectively. The percentage of patient in CG who developed hypotension in the 3rd and 4th is 44% and 32% compared to 8% and 0% in EphG, with significant differences (P-value 0.004 and 0.002, respectively). Administration of small dose of ephedrine with propofol could attenuate propofol/fentanyl hypotensive and bradycardic effects.