Background: In general, most parturients with no contraindications receive spinal anesthesia for cesarean section. The incidence of hypotension is high and this leads to decreased uteroplacental blood flow with possible fetal acidemia.

Objectives: To study the efficacy of ephedrine infusion prophylaxis for hypotension associated with spinal anesthesia for elective cesarean sections compared with traditional preloading. The outcomes of this study were the incidence of hypotension during the operation, neonatal outcomes and the side effects of ephedrine.

Method: With a concealed randomized study, 96 parturients were allocated into two groups, the study group received ephedrine 18 mg (3 ml) added to 100 ml normal saline, while the control group received 3 ml of normal saline instead of ephedrine intravenous continuous infusion given over 10 minutes. All patients had preloading fluid with lactated Ringer's solution 20 ml/kg 10 minutes before being injected with 0.5% hyperbaric bupivacaine mixed with preservative free morphine at intervertebral lumbar space 3-4 or 4-5.

Results: The incidence of hypotension was 93.8% in the control group and 85.4% in the study group (p = 0.181). Neonatal outcomes, as measured by Apgar scores at 1 and 5 minutes, were the same in each group. Other side effects such as reactive hypertension, palpitations, tachycardia and headaches were not different between the groups.

Conclusion: The results of the study indicate that there is no significant advantage from using ephedrine infusion (18 mg) for the prophylaxis of hypotension during spinal anesthesia for cesarean sections, compared with standard treatment.