Author/Editor		Zorko, Nuška; Kamenik, Mirt
Title		The effect of Trendelenburg position, lactated Ringer solution and 6 % hydroxyethyl starch solution on cardiac output after spinal anesthesia
Type		članek
Source		In: Intensivcare Anaesthesia [Klagenfurt : s. n.]
Publication year		2009
Volume		str. 1 PDF datoteka (str. 1-12)
Language		eng
Abstract		The aim of our study was to evaluate the effects of Trendelenburg position combined with infusion of 6% hydroxyetyl starch solution, or lactated Ringer's solution on changes in cardiac output (CO) after spinal anesthesia in patients older than 50 years. Seventy patients scheduled for lower extremity orthopedic surgery under spinal anesthesia were allocated randomly to one of the three treatment groups. In the Trendelenburg position group (Trendelenburggroup) , the patients were placed in the Trendelenburg position immediately after the spinal block for 10 minutes. In the 6% hydroxyethyl starch (HES group) and the lactated Ringer's (lactated Ringer group) groups, the patients received an infusion of 500 mL of 6% hydroxyethyl starch solution or 1000 mL of lactated Ringer's solution over 20 minutes after the spinal block. CO was measured continuously from 15 minutes before and 30 minutes after spinal anesthesia using impedance cardiography method and blood pressure with an automated device. P < 0.05 was considered statistically significant. The differences between treatment groups in CO were not statistically significant. Differences in the CO changes from baseline over time were significant over time. In the Trendelenburg group CO did not change while the patient was in the Trendelenburg position. In the HES group CO increased significantly after the block and remained significantly increased until the end of measurements. In the lactated Ringer's group CO increased significantly 10 and 20 minutes after the block, but after stopping the infusion CO started to decrease. Our study demonstrated that a decrease in CO after spinal anesthesia is prevented by placing the patient in the Trendelenburg position, or infusion of either lactated Ringer's solution or 6% hydroxyetyl starch solution. While the effects of the infusion of the lactated Ringer's solution are transient, the effects of the infusion of 6% hydroxyethyl starch solution are extended beyond the time the infusion.
Descriptors		Orthopedics Ortopedija Cardiac Output Srčni iztis Anesthesia, Spinal Spinalna anestezija Head-Down Tilt Glava-navzdol lega
Keywords		Ringerjeva raztopina hidroksietil