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Bolus injection of Ringer's solution and dextran 1 kDa during induction of spinal anesthesia
South Hospital, and Karolinska Institute, Stockholm, Sweden.
South Hospital, and Karolinska Institute, Stockholm, Sweden.
2005 (English)In: Acta Anaesthesiologica Scandinavica, ISSN 0001-5172, E-ISSN 1399-6576, Vol. 49, no 2, 152-159 p.Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Arterial hypotension following induction of spinal anesthesia is difficult to prevent with infusion fluids. In a randomized, unblinded and controlled study we evaluated whether a rapid fluid administration planned according to volume kinetic analysis is followed by a more stable blood pressure.

METHODS: Spinal anesthesia was induced in 75 surgical patients, using one of three different fluid regimens: intravenous 'bolus injection' of 5 ml kg(-1) of Ringer's acetate over 3 min, 2 ml kg(-1) of low-molecular weight (1 kDa) dextran over 3 min, or a constant-rate infusion of 15 ml kg(-1) of Ringer's acetate over 40 min (controls). The kinetics of the fluid was studied in five patients in each group and also in eight volunteers.

RESULTS: The decrease in mean arterial pressure averaged 28%, 27% and 26%, respectively, and was fully developed 16 min after the induction. The height of the block, but not the fluid programme, correlated with the hypotension. Nausea or near-fainting associated with marked hypotension or bradycardia was recorded in none, five (20%) and two (8%) of the patients, respectively. Both bolus injections were followed by translocation of fluid from the peripheral tissues to the bloodstream, which maintained the plasma dilution at about 10% for at least 30 min until surgery began.

CONCLUSION: A brisk infusion of Ringer's solution or dextran 1 kDa over 3 min was followed by the same decrease in arterial pressure as a longer and 3-5-times larger infusion of Ringer's solution over 40 min during induction of spinal anesthesia.

Place, publisher, year, edition, pages
Wiley-Blackwell, 2005. Vol. 49, no 2, 152-159 p.
National Category
Medical and Health Sciences
URN: urn:nbn:se:liu:diva-100175DOI: 10.1111/j.1399-6576.2004.00561.xPubMedID: 15715614OAI: diva2:660659
Available from: 2013-10-30 Created: 2013-10-30 Last updated: 2013-11-06Bibliographically approved

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Hahn, Robert G.
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