Şaziye ŞAHİN, Filiz SARI, Alpaslan APAN, Hülya BAŞAR

Spinal anestezideki hipotansiyonun önlenmesinde, farklı zaman ve kombinasyonlarda uygulanan ringer laktat ve HES solüsyonlarının etkileri

Amaç: Bu çalışmada, spinal anesteziye bağlı hipotansiyonu önlenmek için kullanılan kristaloid ve kolloid sıvılar ile, bu sıvıların farklı uygulama zamanlarının etkinliğinin araştırılması amaçlandı. Yöntem: Çalışmaya alınan ASA I-II grubu 100 hasta, beş gruba ayrıldı. Grup I'e spinal anesteziden önceki 30 dk içinde 1000 mL Ringer laktat (RL), Grup II'ye 500 mL %6 HES, Grup III'e spinal anesteziden önceki 15 dk içinde 500 mL RL ve spinal anesteziden sonraki ilk 15 dk içinde 250 mL %6 HES, Grup IV'e ve Grup Ve aynı periyodlarda sırası ile 500'mLRL + 500 mL RL, ve 250 mL %6 HES + 250 mL %6 HES uygulandı. İlk 20 dakika boyunca her dakika, daha sonra 5 dakikada bir sistolik, diyastolik, ortalama arter basınçları ve kalp atım hızları kaydedildi. Spinal uygulamadan sonraki 5., 10. ve 15. dakikalardaki duyusal blok seviyeleri tesbit edildi. Bulgular: Grup III ve IV ile grup IVveVarasında 2., 3. ve 5. dakikalardaki diyastolik arter basınçları dışında arter basınçları ve kalp atım hızları açısından fark gözlenmedi. Sonuç: Spinal anestezi sonrası hipotansiyon oluşumunda blok seviyesinin önemli olduğu, spinal anestezi öncesi kullanılan sıvıların niteliği, miktarı ve uygulama zamanı açısından bir fark olmadığı sonucuna varıldı.

Anahtar Kelimeler:

Anestezi, spinal, İzotonik solüsyonlar, Hipotansiyon

The effects of lactated ringer and HES solutions in differing combinations to prevent hypotension due to spinal anesthesia

Objective: The aim of this study was to assess the effectiveness of preloading with crystalloid and colloid fluids on hypotension following spinal anaesthesia. Method: One hundred ASA Class I-II patients were randomly assigned to the study and divided into five groups. Group I: Lactated Ringer (LR) 1000 mL 30 minutes before spinal anaesthesia, Group II: HES %6 500 mL solution before the procedure, Group III: 500 mL RL before and HES %6 250 mL within 15 minutes after the procedure. Group IV and Group V received RL 500 mL + 500 RL mL, and HES %6 250 mL + HES %6 250 mL respectively, using the same timing protocol. Systolic, diastolic and mean arterial pressures and heart rates were measured at 1 minute intervals in the first 20 minutes and then every 5 minutes. Results: With the exception of the differences in diastolic blood pressures at the 2nd, 3rd, and 5th minutes, there was no difference in arterial blood pressures and heart rates between Group HI and IV or Group TV and V. Conclusion: While significant correlation was found between spinal block level and the incidence of spinal hypotension, no difference was observed regarding the type, dosage, and timing of loading solutions before spinal anaesthesia.

Keywords:

Anesthesia, Spinal, Isotonic Solutions, Hypotension,

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