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Nephrolithotripsy Surgery Using Spinal Anesthesia Method: a Comparison in Hemodynamic Changes between the Patients Injected Atropine and Ephedrine

As the acute hypotension developed from sympathetic blockage resulting due to spinal anesthesia after surgical operations such as PCNL is always remain a controversial issue. This study was conducted with the aim of comparing the hemodynamic changes after injecting atropine and ephedrine before prone position in patients undergoing nephrolithotripsy surgical operation through spinal anesthesia. A total of 90 subjects (patients) for PCNL through spinal anesthesia with ASA Class I and II, no migraine and chronic headaches, no cardiovascular disease, no coagulation disorder, having an age range in between 2060 years old were chosen and categorized into three groups. The first and second groups were injected 5 mg of atropine and 5 mg of ephedrine immediately before the prone position, while the third group received no medication. Systolic blood pressure, diastolic blood pressure, respiration, venous oxygen saturation, and the patient's pulse were recorded at every five minutes gaps after surgery. Statistical results revealed a significant difference between the three groups of atropine, ephedrine, and control in terms of systolic blood pressure before the prone position, immediately after the prone position, 5, 15, and 25 min after it. The changes in the diastolic blood pressure across the three groups of atropine, ephedrine, and control immediately after the prone position and 25 min after it was statistically significant. The variations of the heart rate were also significant between the three groups before the prone position, immediately after the prone position, 5, 10, 15, and 25 min after it. The results obtained from this study indicate that to prevent hypotension resulting from spinal anesthesia following PCNL surgery, in which the patient adopts a prone position, prophylactic prescription of atropine and ephedrine immediately before the prone position can reduce the extent of hypotension.