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document
Incidence and time course of cardiovascular side effects during spinal anesthesia after prophylactic administration of intravenous fluids or vasoconstrictors . UNLABELLED We studied the time course of arterial hypotension and/or bradycardia requiring treatment during spinal anesthesia and compared the efficacy of i.v . fluid or vasoconstrictor administration for the prevention of these side effects . Patients ( n = 1066 ) were randomly allocated to either a volume group ( lactated Ringer 's solution 15 mL/kg within 15 min before spinal anesthesia ) , a dihydroergotamine group ( 10 microg/kg i.m . 15 min before anesthesia ) , or a placebo group . All patients breathed O2-enriched air during spinal anesthesia ( 4 mL of plain 0.5 % bupivacaine ) . With the placebo , there were side effects ( mean incidence 22.9 % ) for up to 45 min after the start of anesthesia . Dihydroergotamine reduced the incidence of side effects , preferentially the late ones , more ( mean incidence 11.8 % ) than fluid administration ( mean incidence 16.9 % ) , which was effective only during the first 15 min of anesthesia . Both heart rate and arterial pressure decreased within 15 min before the manifestation of symptoms . In a subgroup of patients , the incidence of side effects ( 8 % ) was greatly reduced by the intraoperative application of both sedatives and opioids . We conclude that cardiovascular side effects may occur at any time during spinal anesthesia . Fluid administration reduced the incidence of early events , but dihydroergotamine the late events . IMPLICATIONS Cardiovascular side effects requiring treatment occurred at any time during spinal anesthesia in our placebo-controlled study , regardless of the prophylactic regimen ( fluid infusions versus dihydroergotamine ) .
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Intervention_Pharmacological
spinal anesthesia
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Intervention_Pharmacological
intravenous fluids
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Intervention_Pharmacological
vasoconstrictors
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Intervention_Pharmacological
fluid
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Intervention_Pharmacological
vasoconstrictor
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Intervention_Pharmacological
lactated Ringer 's solution
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Intervention_Pharmacological
dihydroergotamine
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Intervention_Physical
anesthesia
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Intervention_Control
placebo group
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Intervention_Physical
spinal anesthesia
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Intervention_Pharmacological
bupivacaine
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Intervention_Control
placebo
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Intervention_Pharmacological
Dihydroergotamine
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Intervention_Control
placebo-controlled
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Intervention_Pharmacological
fluid infusions
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Intervention_Pharmacological
dihydroergotamine
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Outcome_Adverse-effects
cardiovascular side effects
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Outcome_Adverse-effects
side effects
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Outcome_Adverse-effects
incidence of side effects
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Outcome_Physical
heart rate and arterial pressure decreased
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Outcome_Adverse-effects
incidence of side effects
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Outcome_Adverse-effects
cardiovascular side effects
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Outcome_Other
incidence of early events
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Outcome_Other
late events .
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Outcome_Other
Cardiovascular side effects
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Participant_Condition
spinal anesthesia after prophylactic administration of intravenous fluids or vasoconstrictors .
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Participant_Condition
spinal anesthesia
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Participant_Sample-size
1066