Üreterorenoskopi için spinal anestezi sırasında kristalloid preloada karşı kristalloid koload: Randomize kontrollü çalışma
Abstract
Amaç: Spinal anestezi sırasında optimal sıvı yönetimi stratejisi hala belirsizdir. Bu çift kör randomize
çalışmada, üreterorenoskopi yapılan hastalarda spinal anestezi için sıvı uygulamasının
zamanlamasını değerlendirdik.
Gereç ve Yöntem: Anestezi alması planlanan 60 ASA I-III hasta, 500 ml kristalloid preload (spinal
anesteziden 30 dakika önce) veya 500 ml kristalloid koload (spinal anestezinin başlangıcında) alacak
şekilde rastgele ayrıldı. Sistolik kan basıncı, bazal değerin %20'sinden daha fazla azaldığında, Efedrin
5 mg bolus uygulandı. Kalp atım hızı 50 atım/dakikaya düşen hastalara atropin 0,5 mg verildi. Ameliyat
sırasında hemodinamik değişkenler kaydedildi.
Bulgular: Gruplar demografik veriler ve cerrahi süre açısından karşılaştırıldı. Gruplar arasında
demografik veriler ve operasyon süreleri açısından herhangi bir fark saptanmadı. Grup II'de sadece bir
hastada efedrin gereksinimi olurken Grup I'de hiçbir hastaya efedrin uygulanmadı. Her iki grupta da
hiçbir hastada bradikardi için atropine ihtiyaç duyulmadı. Gruplar arasında efedrin ve atropine
gereksinimi açısından herhangi bir fark saptanmadı.
Sonuç: Üreterorenoskopi yapılan hastalarda, spinal anestezi öncesi ve spinal anestezi sırasında
uygulanan kristalloid infüzyonları, vazopressör ajanlarına ihtiyaç açısından farklılık oluşturmamaktadır
Keywords
References
- 1.Mercier FJ. Fluid loading for cesarean delivery under spinal anesthesia: Have we studied all the options?. Anesth Analg 2011; 113 (4):6 77-80. https://doi: 10.1213/ANE.0b013e3182245af4.
- 2. McDonald S, Fernando R, Ashpole K, Columb M. Maternal cardiac output changes after crystalloid or colloid coload following spinal anesthesia for elective cesarean. Anesth Analg 2011; 113 (4): 803-10. https://doi: 10.1213/ANE.0b013e31822c0f08.
- 3. Morgan PJ, Halpern SH, Tarshis J. The effects of an increase of central blood volume before spinal anesthesia for cesarean delivery: A qualitative systematic review. Anesth Analg 2001; 92 (4): 997-1005. https://doi: 10.1097/00000539-200104000-00036.
- 4. Sharma SK, Gajraj NM, Sidawi JE. Prevention of hypotension during spinal anesthesia: a comparison of intravascular administration of hetastarch versus lactated Ringer's solution. Anesth Analg 1997; 84 (1): 111-14. https://doi: 10.1097/00000539-199701000-00021.
- 5. Ngan Kee WD. Prevention of maternal hypotension after regional anesthesia for cesarean section. Curr Opin Anaesthesiol 2010; 23 (3): 304-9. https://doi: 10.1097/ACO.0b013e328337ffc6.
- 6. Özyalçın SN, Raj PP, Erdine S, Heavner J, Aldemir T, Yücel A. Rejyonal Anestezi. İstanbul: Nobel Tıp Kitabevleri 2005;159-84.
- 7. Klöhr S, Roth R, Hofmann T, Rossaint R, Heesen M. Definitions of hypotension after spinal anasthesia for cesarean section: literature search and application to parturients. Acta Anasthesiol Scand 2010; 54 (8): 909-21. https://doi: 10.1111/j.1399-6576.2010.02239.x.
- 8. Carpenter RL, Caolan RA, Brown DL, Stephenson C, Wu R. Incidence and risk factors for side effects of spinal anesthesia. Anesthesiology 1992;76(6):906-16.
- 9. Stuart JC, Gin T, Critchley LAH, Short TG. Haemodynamic effects of subarachnoid block in elderly patients. Br J Anaesth 1994; 73 (4): 464-70. https://doi: 10. 1093/bja/73.4.464.
- 10. Rout CC, Rocke DA, Levin J, Gouws E, Reedy D. A reevaluation of the role of crystalloid preload in the prevention of hypotension associated with spinal anesthesia for elective cesarean section. Anesthesiology 1993; 79 (2): 262-9. https://doi: 10.1097/00000542-199308000-00011.
- 11. Park GE, Hauch MA, Curlin F, Datta S, Bader AM. The effects of varying volumes of cyristalloid administration before cesarean delivery on maternal hemodynamics and colloid osmotic pressure. Anesth Analg 1996; 83 (2): 299-303.
- 12. Dyer RA, Farina Z, Joubert IA, et al. Crystalloid preload versus rapid crystalloid administration after induction of spinal anaesthesia (coload) for elective caesarean section. Anaesth Intensive Care 2004; 32 (3): 351-7. https://doi: 10.1177/0310057X0403200308.
- 13. Sakabe T. Rejyonel Anestezi. Çeviri: Ateş Y. In: Morgan GE, Mikhail MS, Murray MJ (ed). Klinik Anesteziyoloji (Lange) 4. Baskı, Çeviri Editörü: Tulunay M, Cuhruk H., Ankara, Güneş Kitabevi 2008; 289-324.
- 14. Kayhan Z (ed). Santral Bloklar In: Klinik Anestezi, 3. Baskı. İstanbul: Logos Yayıncılık 2004
Crystalloid preload versus crystalloid coload during spinal anesthesia for ureterorenoscopy: A randomized controlled trial
Abstract
Aim: The optimal strategy of fluid administration during spinal anesthesia is still unclear. In this
double-blind randomized study, we assessed the timing of fluid administration for spinal anesthesia in
patients undergoing ureterorenoscopy.
Materials and Methods: 60 ASA I-III patients scheduled for anesthesia were randomly allocated to
receive either 500 ml crystalloid preload (30 minutes before spinal anesthesia) or 500 ml crystalloid
coload (at the start of spinal anesthesia). Ephedrine 5 mg boluses were administered when the
systolic blood pressure decreased more than 20% of the baseline value. Atropine 0.5 mg was given to
the patients whose heart rate decreased bellow 50 beats/minutes. Hemodynamic variables were
recorded during the surgery.
Results: The groups were compared in terms of demographic data and surgical time and there was
no difference between them. In Group II, only 1 patient needed ephedrine, while in Group I, no patient
was administered ephedrine. No patients in both groups needed atropine for bradycardia. There was
no difference between the groups in terms of the need for ephedrine.
Conclusion: Crystalloid preload and crystalloid coload administration do not differ in terms of the need
for vasopressor agents in patients undergoing ureterorenoscopy under spinal anesthesia
Keywords
References
- 1.Mercier FJ. Fluid loading for cesarean delivery under spinal anesthesia: Have we studied all the options?. Anesth Analg 2011; 113 (4):6 77-80. https://doi: 10.1213/ANE.0b013e3182245af4.
- 2. McDonald S, Fernando R, Ashpole K, Columb M. Maternal cardiac output changes after crystalloid or colloid coload following spinal anesthesia for elective cesarean. Anesth Analg 2011; 113 (4): 803-10. https://doi: 10.1213/ANE.0b013e31822c0f08.
- 3. Morgan PJ, Halpern SH, Tarshis J. The effects of an increase of central blood volume before spinal anesthesia for cesarean delivery: A qualitative systematic review. Anesth Analg 2001; 92 (4): 997-1005. https://doi: 10.1097/00000539-200104000-00036.
- 4. Sharma SK, Gajraj NM, Sidawi JE. Prevention of hypotension during spinal anesthesia: a comparison of intravascular administration of hetastarch versus lactated Ringer's solution. Anesth Analg 1997; 84 (1): 111-14. https://doi: 10.1097/00000539-199701000-00021.
- 5. Ngan Kee WD. Prevention of maternal hypotension after regional anesthesia for cesarean section. Curr Opin Anaesthesiol 2010; 23 (3): 304-9. https://doi: 10.1097/ACO.0b013e328337ffc6.
- 6. Özyalçın SN, Raj PP, Erdine S, Heavner J, Aldemir T, Yücel A. Rejyonal Anestezi. İstanbul: Nobel Tıp Kitabevleri 2005;159-84.
- 7. Klöhr S, Roth R, Hofmann T, Rossaint R, Heesen M. Definitions of hypotension after spinal anasthesia for cesarean section: literature search and application to parturients. Acta Anasthesiol Scand 2010; 54 (8): 909-21. https://doi: 10.1111/j.1399-6576.2010.02239.x.
- 8. Carpenter RL, Caolan RA, Brown DL, Stephenson C, Wu R. Incidence and risk factors for side effects of spinal anesthesia. Anesthesiology 1992;76(6):906-16.
- 9. Stuart JC, Gin T, Critchley LAH, Short TG. Haemodynamic effects of subarachnoid block in elderly patients. Br J Anaesth 1994; 73 (4): 464-70. https://doi: 10. 1093/bja/73.4.464.
- 10. Rout CC, Rocke DA, Levin J, Gouws E, Reedy D. A reevaluation of the role of crystalloid preload in the prevention of hypotension associated with spinal anesthesia for elective cesarean section. Anesthesiology 1993; 79 (2): 262-9. https://doi: 10.1097/00000542-199308000-00011.
- 11. Park GE, Hauch MA, Curlin F, Datta S, Bader AM. The effects of varying volumes of cyristalloid administration before cesarean delivery on maternal hemodynamics and colloid osmotic pressure. Anesth Analg 1996; 83 (2): 299-303.
- 12. Dyer RA, Farina Z, Joubert IA, et al. Crystalloid preload versus rapid crystalloid administration after induction of spinal anaesthesia (coload) for elective caesarean section. Anaesth Intensive Care 2004; 32 (3): 351-7. https://doi: 10.1177/0310057X0403200308.
- 13. Sakabe T. Rejyonel Anestezi. Çeviri: Ateş Y. In: Morgan GE, Mikhail MS, Murray MJ (ed). Klinik Anesteziyoloji (Lange) 4. Baskı, Çeviri Editörü: Tulunay M, Cuhruk H., Ankara, Güneş Kitabevi 2008; 289-324.
- 14. Kayhan Z (ed). Santral Bloklar In: Klinik Anestezi, 3. Baskı. İstanbul: Logos Yayıncılık 2004
Details
| Primary Language | English |
|---|---|
| Subjects | Health Care Administration |
| Journal Section | Research Articles |
| Authors | |
| Publication Date | September 30, 2020 |
| Submission Date | October 25, 2019 |
| Published in Issue | Year 2020Volume: 59 Issue: 3 |
