90357
document
Intravenous pretreatment of hypertonic saline can prevent systemic hypotension induced by spinal anesthesia . BACKGROUND Hypertonic saline improves organ perfusion and patient survival during hemorrhagic shock because it expands plasma volume and increases tissue oxygenation . Its beneficial results have been reported in patients suffering from hypotension during spinal anesthesia . The purpose of this study was to compare the influence between prehydration with 3 % hypertonic saline and with isotonic lactated Ringer 's solution on the hemodynamic changes and serum electrolyte concentrations in patients undergoing spinal anesthesia . METHODS Sixty ASA class I patients scheduled for herniorrhapy under spinal anesthesia were assigned randomly into two groups . Group 1 = patients were prehydrated with isotonic lactated Ringer 's solution at 7 mg/kg ( n = 30 ) ; Group 2 = patients were given prehydration with 3 % hypertonic saline at 7 ml/kg ( n = 30 ) . Following prehydration , arterial blood pressure and heart rate were recorded and serum electrolyte concentrations were measured . RESULTS The incidence of hypotension was 17/30 ( 57 % ) in the isotonic lactated Ringer 's solution group as against 7/30 ( 23 % ) in the hypertonic saline group ( p < 0.05 ) . There was no significant difference between two groups in relation to the level of anesthesia or maximal heart rate , and electrolyte imbalance did not occur in either group . CONCLUSIONS Prior to spinal anesthesia , hydration with small amount of hypertonic saline is effective to minimize hypotension associated with spinal anesthesia . If so administered it would not increase bodily sodium load and unlike isotonic crystalloid solution it dose not cause accumulation of water in the body on equipollent basis .
90358
Intervention_Pharmacological
hypertonic saline
90359
Intervention_Pharmacological
hypertonic saline and with isotonic lactated Ringer 's solution
90360
Intervention_Surgical
herniorrhapy
90361
Intervention_Pharmacological
prehydrated with isotonic lactated Ringer 's solution at 7 mg/kg
90362
Intervention_Pharmacological
prehydration with 3 % hypertonic saline at 7 ml/kg
90363
Intervention_Pharmacological
hypertonic saline
90364
Outcome_Physical
systemic hypotension
90365
Outcome_Physical
organ perfusion
90366
Outcome_Mortality
patient survival
90367
Outcome_Physical
arterial blood pressure
90368
Outcome_Physical
heart rate
90369
Outcome_Physical
serum electrolyte concentrations
90370
Outcome_Physical
incidence of hypotension
90371
Outcome_Other
significant difference
90372
Outcome_Physical
level of anesthesia
90373
Outcome_Physical
maximal heart rate
90374
Outcome_Physical
electrolyte imbalance
90375
Participant_Sample-size
Sixty