Original Research Article
Year: 2019 | Month: May | Volume: 6 | Issue: 5 | Pages: 341-352
Effect of Crystalloid and Colloid Preloading on Spinal Induced Haemodynamic Status
Dr. Sanjeev Ahuja1, Dr. Satyendra Kumar Gahlot2
1Assistant Professor, 2Associate Professor;
Dept. of Anaesthesia, GSVM Medical College, Kanpur
Corresponding Author: Dr. Satyendra Kumar Gahlot
ABSTRACT
The present study was designed to evaluate the haemodynamic changes after pre-loading with crystalloids (Hartmann’s solution) and colloids; (Polygelatin and 6% hydroxy-ethyl starch) during spinal anaesthesia. The patients were randomly divided into two groups according to the intravenous infusion they received. In Group - I, patients preloaded intravenously with 1000 ml of crystalloids (Ringer’s lactate) while in Group – II, patients inrtravenously preloaded with 500 ml of hydroxy ethyl starch (Expan 6%) or 500m1 of polygeline. There was no significant changed in pulse rate at different time intervals from baseline in Group II as compared to control group (Group I) (p>0.05). There is significant decrease in mean Systolic Blood Pressure from baseline value in the patients of Group I at different time intervals which was statistically significant (p<0.0001) at 5 minutes (87.89 ± 14.75), at (p<0.01) 15 minutes (77.37 ± 13.27), at (p<0.05) 30 minutes (69.68 ± 12.09). And statistically non significant (p>0.05) at 45 minutes (68.53± 14.12) and at 60 minutes (75.89± 11.57). In patients of Group II the mean Systolic Blood Pressure was found to be descreased during the late hours of the study as compared to baseline values. The hypotension was maximum at 30 minutes (115.2 ± 11.67) than at 60 minutes (117.40 ± 9.21) and statistically significant (p<0.05) and was minimum (p>0.05) at 15 minutes (120.00 ± 10.04) but at 5 minutes the mean Systolic Blood Pressure was increased by (1.70 ± 10.10 mm Hg) from baseline values insignificantly (p>0.05). The change in Diastolic Blood Pressure among the patients of both groups ever one hour period was not found to be statistically significant (p>0.05). Average decrease in Systolic Blood Pressure was 8 mm Hg in the Group II receiving colloid solution (H.E.S 6%, Polygeline). The crystalloid Group I experienced a drop in Systolic Blood Pressure of >25mm Hg. The Blood Pressure decrease was significantly greater in the crystalloid group. The Mean intravenous fluid infused during spinal anaesthesia in control Group I was 1021.67 ± 296.15 ml. This supplemented fluid was less (673.34 ± 176.04) in Group II from control group which was statistically significant (p<0.001). Infusion of 1000 ml of crystalloid fluid, PCV was decreased more in colloid Group II than the control Group I and it was statistically significant. (p<0.001). Colloids especially Hydroxyethyl starch appears to be the best intravenous preloading agent to overcome the problem of hypotension during spinal anaesthesia.
Key words: Spinal anaesthesia, Crystalloid and Colloid Preloading, Spinal Induced Haemodynamic Status
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