Evaluation of the Ephedrine Test

D. LeRoy Crandell, MD
JAMA. 1963;184(11):904. doi:10.1001/jama.1963.03700240096028.
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To the Editor:  —The article "Evaluation of Ephedrine Test" in The Journal (183:782-783 [March 2] 1963) makes certain inaccurate conclusions as to the clinical value of this test. This evaluation of the "ephedrine response test" is not a well-controlled, statistically significant study. Therefore, accurate conclusions cannot be made with this method of evaluation. The premise that a positive response to ephedrine with subsequent hypotension during anesthesia constitutes a false positive test is a questionable assumption. There are a variety of etiological factors associated with hypotension during anesthesia. It is well known that there is a more frequent incidence of hypotension associated with halothane than with cyclopropane, particularly when administered by individuals in various stages of training. The opposite premise that a negative response to ephedrine without subsequent hypotension during anesthesia constitutes a false negative test is equally questionable. A false negative test may result from a reflex baroreceptor influence.


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