A comparative study of colloid versus crystalloid as preloading infusion for prevention of hypotension in spinal anaesthesia
Journal Title: Medpulse International Journal of Anesthesiology - Year 2019, Vol 9, Issue 1
Abstract
Background: Subarachnoid block is considered a safe regional anaesthesia technique. This technique is widely used for both elective as well as emergency surgical procedures. It is a good anaesthesia technique for surgeries like caesarean section, lower abdominal surgeries, lower limb orthopaedic surgeries and urological procedures. Though spinal anaesthesia has several advantages, it has few disadvantages as well like hypotension, post dural puncture headache, neurological damage etc. As far as hypotension is concerned, both crystalloids and colloids are used as preloading intravenous fluid before spinal anaesthesia. Different crystalloids commonly used in preloading are Ringer lactate, normal saline and colloids that are used in preloading are gelatin, dextran, hetastarch, pentastarch, tetrastarch. We have compared the efficacy of Crystalloid Vs Colloid as preloading infusion for prevention of hypotension in Spinal anaesthesia. Methods: A comparative prospective double blinded randomised study of volume preloading prior to subarachnoid block in lower abdominal surgery with Voluven® and Physiomax TM was undertaken at Meenakshi medical College and Research Institute, Kanchipuram, during April 2017 and August 2018, after institutional Human ethical committee approval and informed consent from the patients. The study population included 60 in-patients belonging to either sex of ASA physical status class I and II undergoing elective lower abdominal surgeries under spinal anaesthesia. The person who administered the fluids was not involved in any part of the study further. Afterwards spinal block was given and both intraoperative and post-operative observations and parameters in the study were noted. Results: Sixty patients in the age group of 18 to 70 years were randomly allocated into two groups. Group A consisted of 30 patients who received 10 ml/kg of colloid (Voluven®) as preloading fluid 20 minutes prior to spinal anaesthesia and Group B received 10 ml/kg of crystalloid (Physiomax™).The incidence of hypotension in Colloid group was 10% and in Crystalloid group 57%. The requirement of vasopressor Ephedrine to counter hypotension was significantly less in Colloid group when compared to Crystalloid group. Conclusion: It can be concluded from the present study that Colloids (Voluven®) offset hypotension and hypovolemia more effectively than Crystalloids (Physiomax™) in patients scheduled for elective lower abdominal surgery under spinal anesthesia.
Authors and Affiliations
Mohammed Bishar, B Anand, Selvakumaran . , U G Thirumaaran
Keywords
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- EP ID EP520936
- DOI 10.26611/10159117
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