A Comparison Between Preloading With Voluven or Lactated Ringer's Solution on Hemodynamic Status During Lower Extremity Orthopedic Procedures



Masoudifar M¹ ; Reza Hadi M² ; Mehrabi Koushki A³ Show Affiliations
Source: Journal of Isfahan Medical School Published:2013

Abstract

Background: Spinal anesthesia is often recommended as a safe and preferred substitute for general anesthesia. The hemodynamic benefits of spinal anesthesia over general anesthesia include a minimum decrease in myocardial contractility and only modest decreases in blood pressure and cardiac output. However, spinal anesthesia is associated with some complications (such as unstable hemodynamic status) during surgery that may lead to mortality in patients under operation. Hydroxyethyl starch (Voluven) is a substance used to preserve a patient's hemodynamic stability during surgery. This study compared the use of lactated Ringer's solution and Voluven as preload in patients under spinal anesthesia. Methods: This clinical trial study was performed in Kashani Hospital (Isfahan, Iran) during 2012. We selected 80 patients who were scheduled for lower extremity orthopedic procedures under spinal anesthesia. The subjects were randomly allocated to two groups and preloaded with either lactated Ringer's solution or Voluven for 20 minutes. Hemodynamic indexes including blood pressure, heart rate, and oxygen saturation were monitored before the surgery and at the first, third, fifth, tenth, fifteenth, and thirtieth minutes after the operation. The collected data was analyzed with SPSS. Findings: The mean systolic blood pressure in the lactated Ringer±s solution group was 129.3 ±; 16.7 mmHg at baseline and 113.2 ± 16.2 mmHg at the end of the operation. The corresponding values in the Voluven group were 128.1 ±; 14.3 and 113.8 ± 16.1 mmHg. No statistically significant differences were observed between the two groups in terms of systolic or diastolic blood pressure, heart rate, and oxygen saturation. Conclusion: Although using Voluven in spinal anesthesia is supposed to result in better hemodynamic stability, we failed to find a significant difference between Voluven and lactated Ringer±s solution. Therefore, either of them can be used for preloading based on their cost and availability.