PRELOADING VERSUS COLOADING OF CRYSTALLOID FLUID TO CONTROL HYPOTENSION DUE TO SPINAL ANESTHESIA.

Abstract: Maternal hypotension is a serious problem that most commonly occurs after spinal anesthesia in cesarean section. To reduce the incidence of maternal hypotension, mother with spinal anasthesia for cesarean section can be given fluids intravenously using crystalloid or colloid.The purpose of this study was to determine the effect of colloid and crystalloid fluid to blood pressure in mother with spinal anesthesia for cesarean section. This study was cross sectional observational analytic. There were 2 groups in this study, crystalloid group and colloid group. Sampels in each group were 20 subject. Generalized linier models test showed the value of P > 0.05 for each hemodynamic markers (Systolic and diastolic pressure at 5th, 10th, and 15th minutes). On the statistical test value of systolic ( P= 0.379) and diastolic ( P= 0.654). It can be concluded that crystalloid and colloid fluid were equally efective to defend blood pressure in patients with spinal anesthesia for caesarean sectionKeywords: blood pressure, spinal anesthesia, cesarean section, crystalloid, colloid. Abstrak: Hipotensi pada ibu hamil adalah masalah serius yang paling umum terjadi pasca anestesi spinal pada seksio sesarea. Untuk mengurangi kejadian hipotensi tersebut dapat diberikan cairan intravena berupa kristaloid atau koloid. Tujuan penelitian ini untuk membandingkan efek penggunaan cairan koloid dan kristaloid terhadap tekanan darah pasien seksio sesaria dengan anestesi spinal. Penelitian ini bersifat observasional analitik cross sectional. Dua puluh pasien yang telah diberikan cairan kristaloid dan 20 pasien lainnya yang diberikan cairan koloid. Dari uji statistik dengan generaliz linier model didapatkan nilai P= >0.05 pada setiap penanda hemodinamik (TDS dan TDD pada menit ke-5, 10, dan 15). Pada uji statistik tersebut nilai TDS (P = 0.379) dan TDD (P = 0.654). Dapat disimpulkan bahwa cairan kristaloid dan koloid sama efektifnya dalam mempertahankan tekanan darah pada ibu hamil dengan seksio sesarea yang dilakukan anestesi spinal. Kata-kata kunci: tekanan darah, anestesi spinal, seksio sesarea, kristaloid, koloid.

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Comparison the effect of preloading and coloading with crystalloid fluid on the incidence of hypotension after spinal anesthesia in cesarean section

Bali Journal of Anesthesiology ◽

10.4103/bjoa.bjoa_17_19 ◽

2020 ◽

Vol 4 (1) ◽

pp. 3

Author(s):

IMade Artawan ◽

BudiYulianto Sarim ◽

Sidarta Sagita ◽

MariaAgnes Etty Dedi

Keyword(s):

Cesarean Section ◽

Spinal Anesthesia ◽

Crystalloid Fluid

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Implications of Continuous Noninvasive Finger Cuff Arterial Pressure Device Use during Cesarean Delivery for Goal-Directed Fluid Therapy Preload Optimization: A Randomized Controlled Trial

BioMed Research International ◽

10.1155/2021/6685584 ◽

2021 ◽

Vol 2021 ◽

pp. 1-10

Author(s):

Shan-Han Yang ◽

Yi-Shiuan Lin ◽

Chien-Nan Lee ◽

Ya-Jung Cheng ◽

Ying-Hsi Chen ◽

...

Keyword(s):

Arterial Pressure ◽

Stroke Volume ◽

Spinal Anesthesia ◽

Cesarean Delivery ◽

Fluid Therapy ◽

Fluid Challenge ◽

Fixed Dose ◽

Control Group ◽

Crystalloid Fluid ◽

Goal Directed Fluid Therapy

Background. Although fixed-volume conventional fluid preloading protocol fails to attenuate postspinal hypotension during cesarean delivery, the effect of goal-directed fluid therapy (GDFT) remains less explored. Continuous noninvasive finger cuff arterial pressure monitoring using devices such as the ClearSight System can provide the noninvasive stroke volume value, enabling clinicians to perform GDFT before spinal anesthesia; however, the efficacy of GDFT requires further elucidation. Method. In total, 71 consecutive full-term pregnant women were randomly divided into a control group ( n = 34 ) and a GDFT group ( n = 37 ). Before spinal anesthesia, the control group received a fixed dose (1000 mL) of crystalloid fluid, but the GDFT group received repeated 3 mL/kg body weight of crystalloid fluid challenges within 3 minutes with a 1-minute interval between each fluid challenge based on the stroke volume incremental changes obtained using the ClearSight System (targeting a stroke volume increase of ≥5% after a fluid challenge). The primary outcome was the incidence of postspinal hypotension. The secondary outcomes were total fluid volume, vasopressor dosage, hemodynamic parameter changes, maternal adverse effects, and neonatal profiles. Result. Women in the GDFT group received more fluid than did those in the control group ( 1132 ± 108 vs. 1247 ± 202 mL; p = 0.0044 ), but the incidence of postspinal hypotension (79.4% vs. 73.0%,; p = 0.5864 ) and norepinephrine dose ( 12.5 ± 10.6 vs. 15.1 ± 12.8 mcg, respectively; p = 0.3512 ) was comparable between the two groups. Fewer women in the GDFT group experienced nausea (61.76% vs. 35.14%; p = 0.0332 ). Neonatal outcomes (Apgar score and umbilical blood analysis) were comparable and typical in both groups. Conclusion. ClearSight-guided GDFT did not ameliorate postspinal hypotension but may reduce nausea. This trial is registered with NCT03013140.

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A Prospective Comparison of Vasopressor Requirement and Hemody-namic Changes During Spinal Anesthesia for Cesarean Delivery in Patients with Multiple Gestation Versus Singleton Pregnancy

Yearbook of Anesthesiology and Pain Management ◽

10.1016/s1073-5437(08)70942-2 ◽

2008 ◽

Vol 2008 ◽

pp. 201-203

Author(s):

D.H. Chestnut

Keyword(s):

Spinal Anesthesia ◽

Cesarean Delivery ◽

Multiple Gestation ◽

Singleton Pregnancy ◽

Prospective Comparison

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Comparison of Endoscopic Versus Percutaneous Approach (Blind) to Control the Obturator Jerk in Patients Undergoing Transurethral Resection of Bladder Tumors Under Spinal Anesthesia

Bangladesh Journal of Urology ◽

10.3329/bju.v21i2.49885 ◽

2020 ◽

Vol 21 (2) ◽

pp. 120-126

Author(s):

Alamgir Md ◽

Karim Km Monwarul ◽

Nandy SP ◽

Md Monwar Ul Haque ◽

Sakhawat Mahmud Khan

Keyword(s):

Statistical Analysis ◽

Spinal Anesthesia ◽

Transurethral Resection ◽

Bladder Tumor ◽

Complete Resection ◽

Satisfaction Level ◽

Bladder Tumors ◽

Percutaneous Approach ◽

Group A ◽

Group B

Objective: The aim of the study was to compare the endoscopic versus percutaneous approach (blind) to control the obturator jerk in patients undergoing transurethral resection of bladder tumors under spinal anesthesia. Materials and methods: A prospective observational study was performed in Department of Urology, Chittagong Medical College, Chittagong and some Private Hospitals (Ltd.) in Chittagong city during the period from January 2016 to June 2016. Total 100 patients were grouped into two, on alternate basis. Fifty(50) patients in group- A conducted with endoscopic infiltration with 20ml of injection 2% lignocaine at the bladder tumor base and another 50 patients in group-B, conducted with blind percutaneous technique with same drug and volume ( 20ml inj.2% lignocaine) to control obturator jerk. Severity of obturator jerk in both procedure, percentage of complete resection, ONB procedure related time, ONB procedure related complications and surgeon’s satisfaction level were recorded and compared between two approaches. Chi-square analysis was performed to compare the ease of approach and outcome of the two techniques. A value of P<0.05 was considered statistically significant. Results: The mean age of the patients were 59.44+7.681. In group-A, 50 patients were given inj. 2% lignocaine endoscopically at the bladder tumor base to control obturator jerk. Twenty five patients (50%) had no jerk, 20 patients(40%) developed mild jerk and 5 patients (10%) developed moderate jerk and no patients developed severe jerk. Second attempt was taken in moderate jerk patients (5 patients) and succeeded in 3(6%) patients. So, in this group, complete resection of bladder tumor was possible in 96%. In group B, complete resection of bladder tumor was possible in 84%. Statistical analysis was done and result is significant in case of endoscopic procedure to control obturator jerk(p<0.05). ONB Procedure related time was <20 mins. in 32(64%) patients in group-A and 45 (90%) patients in group- B. 20 mins. or more time was required for 18 (36%) patients in group-A and 5 (10%) patients in group-B. Statistical analysis was done and result is significant in percutaneous (blind) technique (p<0.05). ONB procedure related complications in group-A and Group –B were noted. Statistical analysis was done and result is insignificant (p>0.05). Surgeons satisfaction level were recorded on the basis of obturator jerk block and complete resection and which was statistically significant in favour of endoscopy group (p<0.05). Conclusion: It is concluded that endoscopic injection of 2% lignocaine into the bladder tumor base is better in case of jerk elimination and complete resection than blind percutaneous approach. Though, ONB procedure related time was significantly less in percutaneous group. Bangladesh Journal of Urology, Vol. 21, No. 2, July 2018 p.120-126

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