Original Research Article 174 | Page Int J Med Res Prof.2016; 2(4); 174-78. www.ijmrp.com Assessment of Prophylactic Effect of Atropine with Ephedrine in Prevention of Hypotension Induced by Spinal Anaesthesia in Elderly Patients: A Comparative Study Sanjay Jain 1* , Atul Kaushik 2 1* Assistant professor, Department of Anesthesiology, Rama Medical College Hospital & Research Centre, Hapur, Uttar Pradesh, India. 2 Assistant professor, Department of Anesthesiology, School of Medical Sciences and Research, Sharda University, Greater Noida, Uttar Pradesh, India. ABSTRACT Background: Hypotension is one of the major adverse effects seen in patients undergoing spinal anaesthesia and is reported to be seen in more than 30 percent of the cases of patients receiving spinal anaesthesia. It has been highlighted in various studies that the use of atropine and ephedrine in the improvement of hemodynamic parameter when used preoperatively in spinal aesthesia. Hence; we carried this study to evaluate and compare the heart rate and mean arterial pressure after spinal anaesthesia with prophylactic use of atropine, ephedrine and placebo in elderly patients. Materials & Methods: The present study was conducted among 120 patients who underwent surgical procedures under spinal anaesthesia. Patients were randomly divided into three study groups; Group 1 (40 patients): who received normal saline, Group 2 (40 patients) who received 0.6 mg of atropine and Group 3 (40 patients) who received 12 mg of ephedrine. Study drugs were administered to the patients one minute after the spinal anaesthesia. Recording of the various parameters such as amount of vasopressor needed (phenlyephrine), after 15 minutes of spinal anaesthesia, sensory level reached presence of intra-operative angina and intra/postoperative confusion and other side effects till six hours post-surgically was done. All the results were analyzed by SPSS software. Results: MAP at the baseline time in the three study groups was found to be 98.5, 91.5 and 93.7 respectively. 14 patients in the group 3 were observed to have bradycardia while none of the patients in group 1 and group 2 suffered from bradycardia at baseline. Significant results were obtained while comparing the mephentemine used and amount of patients affected by bradycardia when compared in between the various study groups. Conclusion: It can be concluded that profile of atropine is better as compared to ephedrine in the maintenance of hemodynamic in elderly patients. Key Words: Anaesthesia, Hypotension, Spinal. *Correspondence to: Dr Sanjay Jain, Assistant professor, Department of Anesthesiology, Rama Medical College Hospital & Research Centre, Hapur, Uttar Pradesh, India. Article History: Received: 22-06-2016, Revised: 12-07-2016, Accepted: 29-07-2016 Access this article online Website: www.ijmrp.com Quick Response code DOI: 10.21276/ijmrp.2016.2.4.042 INTRODUCTION Spinal anaesthesia is being used as a routine procedure for carrying out various surgical procedures since long time. After the insertion of the needle in the plane of neuraxis, sympathetic block, sensory analgesia and motor block, depending on dose, concentration, or volumes of local anaesthetics are produced by this procedure. One of the major disadvantages of the spinal block is the precipitous hypotension. Hypotension is reported to be seen in more than 30 percent of the cases of patients receiving spinal anesthesia. 1,2 Hypotension occurring after spinal blockage is further precipitated by the absence of significant amount of reflex tachycardia. Blockade of cardio accelerator sympathetic fibers at T1 to T4, and possibly the “reverse” of the Bainbridge reflex are further responsible for occurrence of these phenomenons. One of the prominent mechanisms producing hypotension is the sympathetic blockage leading to the systemic vasodialation after the administration of spinal anaesthesia. One of the current topics of research is the search such of a technique or combinations to prevent spinal anaesthesia induced hypotension and bradycardia. 3,4 Various studies have highlighted the use of atropine and ephedrine in the improvement of hemodynamic parameter when used preoperatively in spinal aesthesia. 5,6 Hence; we carried this study to evaluate and compare the heart rate and mean arterial pressure after spinal anaesthesia with prophylactic use of atropine, ephedrine and placebo in elderly patients. MATERIALS & METHODS The present study was conducted in the department of medicine and anaesthesiology of the institution and included prospective