The effect of oral etilefrine premedication on the incidence of hypotension during spinal anaesthesia

This study was designed to determine the efficacy of oral etilefrine in preventing hypotension induced by spinal anaesthesia. Forty patients, ASA grade I or II, aged 23-60 years, scheduled for orthopaedic surgery involving the lower extremity under spinal anaesthesia were studied. The patients were randomly allocated to one of two groups; the etilefrine group (n = 20) received oral etilefrine 15 mg (30 drops), 60 min before the subarachnoid block, and the control group (n = 20) received no etilefrine. Patients were given 0.5% isobaric bupivacaine intrathecally. Hypotension was defined as a 30% decrease from base-line for systolic arterial pressure and mean arterial pressure or systolic value <90 mmHg, and was treated with intravenous boluses of etilefrine 2 mg. The overall incidence of spinal anaesthesia induced hypotension was 25%, ranging from 20% in the etilefrine group to 30% in the control group. The fall in systolic arterial pressure and mean arterial pressure was significantly greater in the control group than in the etilefrine group (P < 0.05). The patients in the etilefrine group received less etilefrine supplement than those in control group and no subject in the etilefrine group required repeat etilefrine doses, while in the control group five patients received multiple etilefrine doses (P < 0.05). The mean heart rate remained fairly stable throughout the study periods. We conclude that oral etilefrine, given 60 min before surgery, reduces the fall in blood pressure during spinal anaesthesia.