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首页> 外文期刊>Journal of Clinical and Diagnostic Research >Intravascular Administration of Isotonic Saline versus Polymerised Gelatin in the Prevention of Spinal Induced Hypotension: A Randomised Clinical Tria
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Intravascular Administration of Isotonic Saline versus Polymerised Gelatin in the Prevention of Spinal Induced Hypotension: A Randomised Clinical Tria

机译：在预防脊柱诱导的低血压中的等渗盐水与聚合明胶的血管内施用：随机临床三月

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Hypotension remains one of the most common problems associated with subarachnoid blockade.A number of strategies have been developed for its prevention, of which administration of fluids prior to subarachnoid block holds the importance.Gelatin is a colloidal plasma volume expander obtained from degraded gelatine.It is as effective as albumin solution in the treatment of spinal induced hypotension.Aim: To compare the incidence and frequency of hypotension after subarachnoid block in patients receiving colloid (polymerised gelatin) or crystalloid (0.9% normal saline) as prehydration and compare side-effects of colloid and crystalloid prehydration.Materials and Methods: A total of 60 patients scheduled for elective Transurethral Resection of Prostate (TURP) surgery were selected to participate in this prospective randomised double-blind study for a period of two years from April 2006 to April 2008.Patients were randomly allocated into two groups of 30 patients each.Group H received 500 mL of polymerised gelatine (Haemaccel) solution and group N received 1000 mL of 0.9% normal saline15 minutes prior to subarachnoid block.Intraoperative monitoring includes SBP, DBP, MAP and HR for 30 minutes.Incidence of hypotension and number of mephentermine boluses were noted.Statistical analysis of data was determined with Mann-Whitney U test and analysis of variance for repeated measures (ANOVA).Chi-square test was used to find out possible associations.Result: After spinal anaesthesia mean systolic blood pressure decreased in both the groups and was lower in group N compared to group H (97±18.9 vs 102±9.26 mmHg).There was fall in diastolic blood pressure in both the groups and was maximum at 20th minute in group N and group H (66.37±5.47 vs 64.67±10.30).There was highly significant (p<0.01) fall in mean arterial pressure in group N.The change in the heart rate was highly significant (p<0.01) at different time interval in both the groups.Vasopressor was required in 90% and 60% patients in group N and group H, respectively.No statistical difference in the incidence of nausea and vomiting in both the groups.Conclusion: The present study showed that preloading of fluids either with colloids or crystalloids prior to subarachnoid block reduces the incidence of hypotension but not completely eliminating it, also showed that colloids offset hypovolemia and hypotension more effectively than crystalloids in patients undergoing TURP surgery.
机译：低血压仍然是与蛛网膜下腔封闭相关的最常见问题之一。已经开发了其预防的策略数，其中蛛网膜下腔块之前的流体施用了重要性。蛋白是从降解的Gelatine获得的胶体等离子体体积膨胀器。在治疗脊柱诱导的低血压时与白蛋白溶液有效：在接受胶体（聚合明胶）或晶体（0.9％甘蓝盐）作为预水合作用的患者中，比较蛛网膜下腔块后低血压梗死的发病率和频率胶体和晶体预氢化物。材料与方法：选举前列腺（TURP）手术的选修经尿道切除60例患者参加了2006年4月至2008年4月的两年前期两年的前瞻性随机双盲研究。 。将患者随机分配成两组30名患者。群组H收到500毫升聚合的明胶（血质树）溶液和基团接受蛛网膜下块之前的1000ml 0.9％正常的盐水15分钟。反复性监测包括SBP，DBP，MAP和HR，30分钟内易于低血压和Mephentermine推注的数量。统计学用Mann-Whitney U试验和重复措施的差异分析来确定数据分析（ANOVA）.Chi-Square试验用于了解可能的关联。结果：脊髓麻醉后，血压在群体中的收缩压降低与H组（97±18.9毫升102±9.26mmHg）相比，N组中较低。在群体中估算血压下降，在N和H组和H组中最大值（66.37±5.47 Vs 64.67±10.30 ）。在N组中，在平均动脉压下的平均动脉压下降（P <0.01）。心率在群体中不同时间间隔的心率变化非常显着（P <0.01）。载体中需要90％和60％的糖果分别是N和H组的NTS。NO统计学差异在恶心的发病率和群体中的呕吐。结论：本研究表明，在蛛网膜下腔块之前用胶体或晶体预加载流体，降低了低血压的发生率但是不完全消除它，还表明，胶体偏移低血脂和低血压比在接受草坪手术的患者中的晶体更有效。

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