To Study Preloading and Relative Efficacy of Ringer’s Lactate and Pentastarch 6% Prior to Spinal Anaesthesia in Lower Abdominal and Lower Limb Surgeries

Abstract

Background and Objectives: Hypotension after spinal anaesthesia remains a common and a seriouscomplication. Various method have been recommended for the prevention and treatment of this problem.Preloading has become the cornerstone for prophylaxis of hypotension post spinal anaesthesia. This currentstudy reassessed the efficacy of this volume preloading and also compared the efficacy between Ringer’slactate and Pentastarch 6%.Method: In this study, 60 patients (ASA I & II) presenting for elective lower abdominal and lower limbsurgeries under spinal anaesthesia were allocated into two groups, group P and group R to receive 5 ml/kg of6% Pentastarch and 10 ml/kg of Ringer’s lactate preload respectively. After institution of spinal anaesthesiain a sitting position with 3.8 ml of Bupivacaine 0.5% (heavy) using 23G Quincke spinal needle, patientswere made to assume supine position. The heart rate(HR), systolic blood pressure(SBP) and diastolic bloodpressure(DBP) were monitored intra-operatively every 2 minutes for first 10 minutes and every 5 minutesfor next one hour and every 15 minutes thereafter. Electrocardiogram (ECG) and oxygen saturation(SpO2)were monitored continuously. The amount of ephedrine, used intra-operatively were noted and comparedamong the different groups.Results: The incidence of hypotension in group R was more than that in group P. There were no significantdifference in HR and the SpO2 between the groups. The difference in mean basal SBP and DBP werestatistically insignificant in both groups. Thereafter, the fall in SBP and DBP was more prominent in groupR at all time intervals with a statistically highly significant difference between the two groups (p value<0.001). The amount of ephedrine used in group R was more than that used in group P. There were minimalcomplications like shivering and vomiting which were statistically non–significant . There were no allergicreactions to the fluids used.Conclusion: Volume preloading, still has a substantial role in reducing the incidence and severity ofhypotension in patients operated under spinal anaesthesia. Pentastarch 6% is found to be a better agent forpreloading, as it is safe and effective in preventing spinal-induced hypotension in patients.