Efficacy of Intravenous Fluid Plasmalyte and 6% Hetastarch in Preventing Spinal Anaesthesia Induced Hypotension in Patients undergoing Lower Abdominal Surgeries: A Randomised Clinical Study
Introduction: Both crystalloids and colloid preloading is recommended for spinal anaesthesia. Preloading of intravenous fluids increases circulating volume and cardiac output; thus preventing spinal anaesthesia-induced hypotension. Crystalloids have a short intravascular half-life, poor plasma e...
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JCDR Research and Publications Private Limited
2021-05-01
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| Series: | Journal of Clinical and Diagnostic Research |
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| Online Access: | https://www.jcdr.net/articles/PDF/14905/48211_CE[Ra1]_F[IK]%20(1)_PF1(AKA_SL)_PN(KM).pdf |
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| author | Prakriti Gupta Suraj Kumar Samiksha Parashar Manoj Kumar Giri Sujeet Rai Deepak Malviya |
| author_facet | Prakriti Gupta Suraj Kumar Samiksha Parashar Manoj Kumar Giri Sujeet Rai Deepak Malviya |
| author_sort | Prakriti Gupta |
| collection | DOAJ |
| description | Introduction: Both crystalloids and colloid preloading is
recommended for spinal anaesthesia. Preloading of intravenous
fluids increases circulating volume and cardiac output; thus
preventing spinal anaesthesia-induced hypotension. Crystalloids
have a short intravascular half-life, poor plasma expanders and
large volumes are thus required.
Aim: To compare the efficacy of 5 mL/kg of 6% Hetastarch
(colloid) to that of 15 mL/kg of Plasmalyte (crystalloid) solution
to prevent hypotension during spinal anaesthesia in patients
undergoing lower abdominal surgeries.
Materials and Methods: This was a randomised clinical trial
from June 2016 to April 2017 on a total 80 patients, belonging
to American Society of Anaesthesiologist (ASA) Grade I and
II scheduled for lower abdominal surgeries under spinal
anaesthesia. They were divided into two groups- Group H and
Group P. Patients in group H were preloaded with 5 mL/kg solution
of 6% Hetastarch, whereas those in group P were preloaded
with 15 mL/kg of Plasmalyte solution. After institution of spinal
anaesthesia with 3.0 mL of hyperbaric Bupivacaine using
25G Quincke’s needle, Blood Pressure (BP) and other vital
parameters were monitored intraoperatively every 3 minutes
for first 30 minutes and then every 5 minutes till the end of
surgery. Descriptive statistics, frequency (n) and percentages
(%) were calculated and the variables between the groups were
compared by Students t-test, Fischers exact test and Mann
Whitney U-test.
Results: Both the groups showed a fall in Mean Blood Pressure
(MBP) immediately after the block. Group P showed more
decline in MBP and Diastolic Blood Pressure (DBP) after the
block and the difference was statistically significant at 9, 12,
15, 18 and 21 minute (p-value <0.05). A 30% patients in group
P as comparison to 10% in Group H required ephedrine for the
treatment of hypotension and found significant (p-value=0.025).
Systolic Blood Pressure (SBP), pulse rate changes and nausea and
vomiting among both groups was non-significant (p-value >0.05).
Conclusion: Pre-loading with 5ml/kg of 6% Hetastarch is more
effective than 15ml/kg of Plasmalyte in preventing hypotension
in patients undergoing lower abdominal surgeries under spinal
anaesthesia. |
| first_indexed | 2024-12-20T00:52:53Z |
| format | Article |
| id | doaj.art-d3f4931216cc4ba5ab247af74b619b0f |
| institution | Directory Open Access Journal |
| issn | 2249-782X 0973-709X |
| language | English |
| last_indexed | 2024-12-20T00:52:53Z |
| publishDate | 2021-05-01 |
| publisher | JCDR Research and Publications Private Limited |
| record_format | Article |
| series | Journal of Clinical and Diagnostic Research |
| spelling | doaj.art-d3f4931216cc4ba5ab247af74b619b0f2022-12-21T19:59:12ZengJCDR Research and Publications Private LimitedJournal of Clinical and Diagnostic Research2249-782X0973-709X2021-05-01155UC26UC3010.7860/JCDR/2021/48211.14905Efficacy of Intravenous Fluid Plasmalyte and 6% Hetastarch in Preventing Spinal Anaesthesia Induced Hypotension in Patients undergoing Lower Abdominal Surgeries: A Randomised Clinical StudyPrakriti Gupta0Suraj Kumar1Samiksha Parashar2Manoj Kumar Giri3Sujeet Rai4Deepak Malviya5Assistant Professor, Department of Anaesthesiology, T.S Misra Medical College, Lucknow, Uttar Pradesh, India.Assistant Professor, Department of Anaesthesiology and Critical Care Medicine, Dr. Ram Manohar Lohia Institute of Medical Sciences, Lucknow, Uttar Pradesh, India.Assistant Professor, Department of Anaesthesiology and Critical Care Medicine, Dr. Ram Manohar Lohia Institute of Medical Sciences, Lucknow, Uttar Pradesh, India.Associate Professor, Department of Anaesthesiology and Critical Care Medicine, Dr. Ram Manohar Lohia Institute of Medical Sciences, Lucknow, Uttar Pradesh, India.Associate Professor, Department of Anaesthesiology and Critical Care Medicine, Dr. Ram Manohar Lohia Institute of Medical Sciences, Lucknow, Uttar Pradesh, India.Professor, Department of Anaesthesiology and Critical Care Medicine, Dr. Ram Manohar Lohia Institute of Medical Sciences, Lucknow, Uttar Pradesh, India.Introduction: Both crystalloids and colloid preloading is recommended for spinal anaesthesia. Preloading of intravenous fluids increases circulating volume and cardiac output; thus preventing spinal anaesthesia-induced hypotension. Crystalloids have a short intravascular half-life, poor plasma expanders and large volumes are thus required. Aim: To compare the efficacy of 5 mL/kg of 6% Hetastarch (colloid) to that of 15 mL/kg of Plasmalyte (crystalloid) solution to prevent hypotension during spinal anaesthesia in patients undergoing lower abdominal surgeries. Materials and Methods: This was a randomised clinical trial from June 2016 to April 2017 on a total 80 patients, belonging to American Society of Anaesthesiologist (ASA) Grade I and II scheduled for lower abdominal surgeries under spinal anaesthesia. They were divided into two groups- Group H and Group P. Patients in group H were preloaded with 5 mL/kg solution of 6% Hetastarch, whereas those in group P were preloaded with 15 mL/kg of Plasmalyte solution. After institution of spinal anaesthesia with 3.0 mL of hyperbaric Bupivacaine using 25G Quincke’s needle, Blood Pressure (BP) and other vital parameters were monitored intraoperatively every 3 minutes for first 30 minutes and then every 5 minutes till the end of surgery. Descriptive statistics, frequency (n) and percentages (%) were calculated and the variables between the groups were compared by Students t-test, Fischers exact test and Mann Whitney U-test. Results: Both the groups showed a fall in Mean Blood Pressure (MBP) immediately after the block. Group P showed more decline in MBP and Diastolic Blood Pressure (DBP) after the block and the difference was statistically significant at 9, 12, 15, 18 and 21 minute (p-value <0.05). A 30% patients in group P as comparison to 10% in Group H required ephedrine for the treatment of hypotension and found significant (p-value=0.025). Systolic Blood Pressure (SBP), pulse rate changes and nausea and vomiting among both groups was non-significant (p-value >0.05). Conclusion: Pre-loading with 5ml/kg of 6% Hetastarch is more effective than 15ml/kg of Plasmalyte in preventing hypotension in patients undergoing lower abdominal surgeries under spinal anaesthesia.https://www.jcdr.net/articles/PDF/14905/48211_CE[Ra1]_F[IK]%20(1)_PF1(AKA_SL)_PN(KM).pdfcolloidscrystalloidsspinal anaesthesiasurgery of lower abdomenhypotension |
| spellingShingle | Prakriti Gupta Suraj Kumar Samiksha Parashar Manoj Kumar Giri Sujeet Rai Deepak Malviya Efficacy of Intravenous Fluid Plasmalyte and 6% Hetastarch in Preventing Spinal Anaesthesia Induced Hypotension in Patients undergoing Lower Abdominal Surgeries: A Randomised Clinical Study Journal of Clinical and Diagnostic Research colloids crystalloids spinal anaesthesia surgery of lower abdomen hypotension |
| title | Efficacy of Intravenous Fluid Plasmalyte and 6% Hetastarch in Preventing Spinal Anaesthesia Induced Hypotension in Patients undergoing Lower Abdominal Surgeries: A Randomised Clinical Study |
| title_full | Efficacy of Intravenous Fluid Plasmalyte and 6% Hetastarch in Preventing Spinal Anaesthesia Induced Hypotension in Patients undergoing Lower Abdominal Surgeries: A Randomised Clinical Study |
| title_fullStr | Efficacy of Intravenous Fluid Plasmalyte and 6% Hetastarch in Preventing Spinal Anaesthesia Induced Hypotension in Patients undergoing Lower Abdominal Surgeries: A Randomised Clinical Study |
| title_full_unstemmed | Efficacy of Intravenous Fluid Plasmalyte and 6% Hetastarch in Preventing Spinal Anaesthesia Induced Hypotension in Patients undergoing Lower Abdominal Surgeries: A Randomised Clinical Study |
| title_short | Efficacy of Intravenous Fluid Plasmalyte and 6% Hetastarch in Preventing Spinal Anaesthesia Induced Hypotension in Patients undergoing Lower Abdominal Surgeries: A Randomised Clinical Study |
| title_sort | efficacy of intravenous fluid plasmalyte and 6 hetastarch in preventing spinal anaesthesia induced hypotension in patients undergoing lower abdominal surgeries a randomised clinical study |
| topic | colloids crystalloids spinal anaesthesia surgery of lower abdomen hypotension |
| url | https://www.jcdr.net/articles/PDF/14905/48211_CE[Ra1]_F[IK]%20(1)_PF1(AKA_SL)_PN(KM).pdf |
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