isotonic saline + ephedrine

Isotonic saline + ephedrine is a therapeutic combination protocol used for the management of hemodynamic stability during spinal anesthesia, particularly in parturients undergoing cesarean section. The protocol involves the intravenous administration of an isotonic saline solution (0.9% sodium chloride) as a 'coload'—delivered simultaneously with the induction of anesthesia—to expand intravascular volume and mitigate the vasodilatory effects of sympathetic blockade. This is supplemented by rescue boluses of ephedrine, a sympathomimetic amine that acts as a non-selective agonist at alpha- and beta-adrenergic receptors. By stimulating these receptors, ephedrine increases cardiac output and peripheral vascular resistance, effectively treating or preventing maternal hypotension. This specific combination was evaluated as the 'standard of care' control arm (Arm T) in a clinical trial conducted by University Tunis El Manar (NCT05434104) comparing standard coloading to ultrasound-guided fluid preloading in hypovolemic patients.

Other names

saline coloading with ephedrine rescueT-University Tunis El Manar-hypotension-hypovolemia