Incidence and management of hypotension in spinal anaesthesia in urological pelvic surgery

Authors

  • Adil Ibraheem
  • Mazin Abdullateef Alzubaidi
  • Muhammed Ibrahim Muhsen
  • Ali Abbas Hashim Almusawi
  • Hayder Abdul-Amir Makki Al-Hindy

DOI:

https://doi.org/10.60988/p.v37i2S.210

Keywords:

hypotension; spinal anaesthesia; urological surgery; ephedrine; intravenous administration

Abstract

The management of hypotension in specific clinical contexts frequently involves the administration of ephedrine; a vasopressor with demonstrated efficacy across multiple scenarios: spinal anaesthesia for uro-pelvic surgery, caesarean section, renal transplantation, and select cases of autonomic dysfunction. Recent evidence suggests that ephedrine use may delay the onset of hypotension. This prospective study has evaluated the incidence and management of hypotension in 80 adult patients (aged 17–45 years) undergoing urological pelvic surgery under spinal anaesthesia. Participants were recruited from the Hilla Teaching Hospital and the Al-Imam Al-Sadeq Teaching Hospital (Iraq) between June 2023 and December 2024, and were randomly assigned to receive either intravenous fluids alone or in combination with ephedrine. Systemic blood pressure was monitored at four time points: preoperatively, following intervention, after anaesthesia induction, and postoperatively. Compared to fluid administration alone, the ephedrine-treated group exhibited significant changes in both systolic and diastolic blood pressure values (p<0.05). These findings suggest that ephedrine enhances haemodynamic stability during spinal anaesthesia and may play a clinically significant role in the intraoperative management of hypotension.

Author Biographies

Adil Ibraheem

Department of Surgery, Hammurabi College of Medicine, University of Babylon, Hillah, Iraq

Mazin Abdullateef Alzubaidi

Department of Surgery, College of Medicine, Al-Mustaqbal University, Hillah, Iraq

Muhammed Ibrahim Muhsen

Department of Surgery, Al-Sadeq Teaching Hospital, Babylon Health Directorate, Hillah, Iraq

Ali Abbas Hashim Almusawi

Hammurabi College of Medicine, University of Babylon, Hillah, Iraq

Hayder Abdul-Amir Makki Al-Hindy

Department of Pharmacology and Toxicology, College of Pharmacy, University of Babylon, Hillah, Iraq

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Published

10-10-2025

How to Cite

[1]
Ibraheem, A. et al. 2025. Incidence and management of hypotension in spinal anaesthesia in urological pelvic surgery. Pharmakeftiki . 37, 2S (Oct. 2025). DOI:https://doi.org/10.60988/p.v37i2S.210.