| Summary: | Hypotension is the most common complication in spinal
anesthesia. One of the prevention effort is made by an administration of coloading
crystalloid. This study aims to compare hypotension incidence in the coloading
administration of Ringerfundin as an isotonic crystalloid and Lactated Ringer as
a hypotonic crystalloid.
Methods : This study was a double blind randomized controlled trials. Subjects
were 82 pregnant women, who undergoing caesarean section with spinal
anesthesia at Dr Sardjito Hospital in Yogyakarta, Panembahan Senopati Hospital
in Bantul and Sleman Hospital. This study was done following institutional ethical
committee approval and obtaining patients written informed consent. Patients
who were selected had normal singleton pregnancy, more than 37 weeks
gestation, 20-40 years old, BMI 20-30 kg/m2, height more than 145 cm, ASA 1-2.
The exclusion criteria included patients with decreased lung compliance,
preeclampsia, eclampsia, hypertension. Drop out criteria were total spinal, failed
spinal. Subject sampling was conducted in consecutive sampling and block
randomly. The patients were divided into two groups, group A (coloading 10
ml/kgbw Lactated Ringer ) and group B (coloading 10 ml/kgbw Ringerfundin).
Fluid administration immediately after CSF detection in spinal needle. Fluid
boluses for both grups were given via a 18G iv catheter with a fully open control
valve and gravity alone providing the driving pressure. Hypotension monitoring
was recorded every 2 minutes for the first 10 minutes following spinal. In
addition, hypotension (25% decrease in baseline BP or SBP < 90 mmHg) could
be treated Ephedrin and additional iv fluid boluses of Lactated Ringer.
Results : There were no statistical significant differences (p=0.792) in
hypotension incidence between Lactated Ringer and Ringerfundin coload
administration.
Conclusion : The coloading isotonic solution (Ringerfundin) has the similar effect
compared to hypotonic solution (Lactated Ringer) to prevent hypotension in
spinal anesthesia during elective caesarean section.
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