A Retrospective Observational Study of Ephedrine Use in Hip Arthroplasty: Routine Practice at a Secondary Care Hospital in Romania.

Background and Objectives: The primary goal of the study is to analyze factors associated with spinal anesthesia-induced hypotension (SAIH), with a focus on ephedrine requirements in relation to patient characteristics and the type of intrathecal opioid used, reflecting real-world clinical practice in a Romanian secondary care hospital. Bolus ephedrine is often required during spinal anesthesia to maintain hemodynamic stability. We conducted a retrospective observational study of patients undergoing total hip arthroplasty. We analyzed the hemodynamic effects of spinal anesthesia to optimize management of spinal anesthesia-induced hypotension (SAIH). Materials and Methods: A total of 329 patients were included in the study, out of which 113 patients were without high blood pressure (60 cases needed Ephedrine) and 216 patients with high blood pressure were drug controlled (106 cases needed Ephedrine). Each group of patients was divided into two groups based on the type of spinal anesthesia: bupivacaine with morphine (Group M) and bupivacaine with fentanyl (Group F). The study explored perioperative factors associated with spinal anesthesia-induced hypotension and the ephedrine dose required to maintain hemodynamic stability. Results: We found that ephedrine dosage correlated with hypertension in 19% of cases and with patient age in 44.1% of cases. The type of anesthetic mixture did not significantly affect the need for intraoperative ephedrine administration. Conclusions: Ephedrine remains essential for ensuring hemodynamic stability and optimizing perioperative outcomes.