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Is crystalloid preloading useful in spinal anaesthesia in the elderly?
Author(s) -
Coe A.J.,
Revanäs B.
Publication year - 1990
Publication title -
anaesthesia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.839
H-Index - 117
eISSN - 1365-2044
pISSN - 0003-2409
DOI - 10.1111/j.1365-2044.1990.tb14696.x
Subject(s) - medicine , anesthesia , preload , ephedrine , spinal anesthesia , blood pressure , heart rate , abdomen , incidence (geometry) , mean arterial pressure , general anaesthesia , surgery , hemodynamics , physics , optics
Summary Sixty ASA grude 1 or 2 patients, aged 60 years or over, scheduled for surgery to the lower abdomen or lower limbs under spinal anaesthesia were allocated randomly to one of three treatment groups. Group A received 16 ml/kg of Ringer's acetate solution immediately before spinal anaesthesia, group B received 8 ml/kg and group C received no volume preload. Heart rate, arterial pressure and anaesthetic level were recorded by an independent observer. The overall incidence of systemic arterial hypotension (defined as a decrease of 25% or more in systolic arterial pressure) was 27%; there were no significant differences among groups. The overall incidence of hypotension was 60%, when temperature sensation was blocked to T 7 and above (n = 25). The number of patients with hypotension which required treatment increased as block height increased above T 7 ; at a level of T 4 or higher, all patients required ephedrine. Crystalloid preloading had no effect on the incidence of hypotension after spinal anaesthesia in fit, elderly patients.