Prevention of spinal anesthesia-induced hypotension in the elderly: comparison between preanesthetic administration of crystalloids, colloids, and no prehydration
| Autor: | Declan O'Brien, Frances O’Donovan, Donal J. Buggy, Ciaran Moran, Maire McCarroll, Patrick Higgins |
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| Rok vydání: | 1997 |
| Předmět: |
Male
medicine.medical_specialty Ringer's Lactate Nausea Plasma Substitutes Blood Pressure Preoperative care Anesthesia Spinal Double-Blind Method Preoperative Care Medicine Humans Colloids Ephedrine Aged Aged 80 and over business.industry Crystalloid Solutions Middle Aged Surgery Anesthesiology and Pain Medicine Blood pressure Anesthesia Polygeline Vomiting Female medicine.symptom Hypotension Isotonic Solutions business Complication Perfusion Haemaccel medicine.drug |
| Zdroj: | Anesthesia and analgesia. 84(1) |
| ISSN: | 0003-2999 |
| Popis: | The practice of routinely prehydrating patients by infusing a crystalloid or colloid solution (up to 1.0 L/70 kg) for prevention of spinal anesthesia-induced hypotension has been challenged recently, after several reports of failure to demonstrate its efficacy in young women. We compared the incidence and frequency of hypotension and vasopressor therapy after spinal anesthesia and no prehydration with crystalloid and colloid prehydration in elderly patients. Eighty-five ASA grade I or II patients (aged 60-89 yr) for elective total hip replacement were randomized to receive 500 mL crystalloid solution (Hartmanns, n = 29), 500 mL colloid (Haemaccel, n = 28), or no prehydration (n = 28) over 10 min prior to spinal anesthesia. Hypotension was defined as a 30% decrease from baseline systolic blood pressure (BP) or systolic < 90 mm Hg, and was treated with ephedrine 3-mg boluses. Although absolute systolic BP readings were significantly higher in the colloid group between 6 and 30 min (P < 0.05), the incidence of hypotension was not significantly different between the groups. The incidence of ephedrine use, incidence of nausea/vomiting, and median total dose of ephedrine were similar in all groups. We conclude that, in elderly patients undergoing elective procedures, withholding prehydration is not associated with any greater degree of hypotension or need for vasopressor therapy compared with crystalloid or colloid prehydration. |
| Databáze: | OpenAIRE |
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