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KMID : 0604019960110020207
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Korean Journal of Critical Care Medicine
1996 Volume.11 No. 2 p.207 ~ p.214
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Comparison of Treatment Methods for Prevention of Hypotension during Spinal Anesthesia
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Abstract
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This study was attempted to compare the effects of three treatment methods for prevention of hypotension during spinal anesthesia. Thirty-eight ASA l and 2 patients(20~50 years) scheduled for elective urologic(genital area) and lower extremity
surgery
under spinal anesthesia were randomly allocated to receive to receive crystalloid preload 15ml/kg over 10~20minutes before spinal anesthesia(crystalloid group, n=13), an ephedrine at a rate of 2mg/min for the first 4 min. and then l mg/min. for
the
next
16 min. after spinal anesthesia (ephedrine group, n=12) or a phenylephrine at a rate of 20㎍/min. for the first 4 min. and then 10㎍/min. for the next 16 min. after spinal anesthesia(phenylephrine group n=130. Hypotension was defined as a
decrease
in
systolic blood pressure (SBP) to less than 90 mmHg or to less than 80% of baseline value. Hypertension was defined as a increase in systolic blood pressure(SBP) more than 10% of baseline value.
@ES The results are as follows.
@EN 1) Hypotension were 3/13(23.1%) in the crystalloid group, 3/12(25.0%) in the ephedrine infusion group and 0/13 in the phenylephrine infusion group. but there were no significant differences in the incidence of hypotension between
groups(P>0.05).
2) In all three groups arterial systolic blood pressure were well maintained(P>0.05; test by group, time and group-time interaction).
3) Heart rates were not well maintained(P<0.05; test by group, time and group-time interaction).
(1) In the crystalloid group heart rate was significantly decreased after 18 minutes(P<0.05 vs baseline value).
(2) In the ephedrine infusion group heart rate was significantly increased between 4~16minutes(P<0.05 vs baseline value).
(3) In the phenylephrine infusion group heart rate was significantly decreased after 4 minutes (P<0.05 vs baseline value).
(4) Heart rate was significantly different between group II and III from 18 to 20 minutes (P<0.05).
4) There were no differences in the incidence of other complications associated with spinal anesthesia(P>0.05).
With the above results, we concluded that all three methods are effective for prevention or minimizing hypotension and maintenance of systolic blood pressure during midthoracic spinal anesthesia.
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KEYWORD
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