Effectiveness of RL preload hydration in preventing hypotension in post-spinal anesthesia patients

Irwadi Irwadi; Andre Utama Saputra

doi:10.31101/ijhst.v6i2.3908

Authors

Irwadi Irwadi Universitas Kader Bangsa, Indonesia
Andre Utama Saputra Universitas Kader Bangsa, Indonesia

DOI:

https://doi.org/10.31101/ijhst.v6i2.3908

Keywords:

hypotension, lactate ringer, spinal anesthesia

Abstract

Hypotension often occurs in spinal anesthesia patients due to suppression of the autonomic nervous system, specifically the sympathetic nerve, leading to vasodilation. This study aims to evaluate the effectiveness of preloading RL in preventing hypotension. The design uses a quasi-experiment with a pretest-posttest design with a control group. A total of 50 respondents were selected by purposive sampling and divided into intervention and control groups. Blood pressure data was measured using a NIBP monitor and recorded on an observation sheet. The results showed that the average systolic and diastolic pressure in the intervention group was 125.20 mmHg and 81.24 mmHg, in the control group was 115.20 mmHg and 70.57 mmHg. The paired sample t-test showed a significant difference (p < 0.05). Preload RL is effective in preventing hypotension in spinal anesthesia.

References

Borse, Dr. Y. M., Patil, Dr. A. P., Subhedar, Dr. R. D., & Sangale, Dr. S. V. (2020). Comparative study of preloading and Co-loading with ringer lactate for prevention of spinal hypotension in elective cesarean section. International Journal of Medical Anesthesiology, 3(1), 30–32. https://doi.org/10.33545/26643766.2020.v3.i1a.66

Castera, M. R., & Borhade, M. B. (2023). Fluid Management. In In StatPearls. Cape Fear Valley Hospital.

CDC. (2020). Postural Hypotensi. Kementrian Kesehatan RI. https://www.cdc.gov/steadi/pdf/steadi-brochure-postural-hypotension-508.pdf

Chen, X., Xu, J., Li, Y., Shen, B., Jiang, W., Luo, Z., Wang, C., Teng, J., Ding, X., & Lv, W. (2021). The Effect of Postoperative Fluid Balance on the Occurrence and Progression of Acute Kidney Injury After Cardiac Surgery. Journal of Cardiothoracic and Vascular Anesthesia, 35(9), 2700–2706. https://doi.org/10.1053/j.jvca.2020.10.007

Chen, Y., Xu, X., Qin, R., Guo, L., & Ni, X. (2023). Comparison of crystalloid and colloid co-load combined with norepinephrine prophylaxis on post-spinal anesthesia hypotension during cesarean delivery: a randomized sequential allocation dose-finding study. Frontiers in Medicine, 10(September), 1–7. https://doi.org/10.3389/fmed.2023.1214598

Dart, A. M., Du, X. J., & Kingwell, B. A. (2022). Gender, sex hormones and autonomic nervous control of the cardiovascular system. Cardiovascular Research, 53(3), 678–687. https://doi.org/10.1016/S0008-6363(01)00508-9

DASM. (2023). Incidence and Associated Factors of Postoperative Undesirable Anesthetic Outcomes Among Surgical Patients at Referral Hospitals in Amhara Region, Ethiopia: A Multi-Center Study. Patient Related Outcome Measures, Volume 14(May), 137–152. https://doi.org/10.2147/prom.s403697

Decuyper, N., & Van De Velde, M. (2023). Fluid co-loading or preloading for the prevention of hypotension during spinal anesthesia for C-section: a narrative review. Acta Anaesthesiologica Belgica, 74(2), 113–121. https://doi.org/10.56126/74.1.09

Eli, C., Aiden, G., Alex, C., Victor, M., Kumar, D., & Livi, S. (2024). Ringer ’ s Lactate in Acute Care : Indications , Mechanisms , and Administration. Reseachgate, August. https://doi.org/10.13140/RG.2.2.19414.46403

Ferre, F., Martin, C., Bosch, L., Kurrek, M., Lairez, O., & Minville, V. (2020a). Control of spinal anesthesia-induced hypotension in adults. Local and Regional Anesthesia, 13, 39–46. https://doi.org/10.2147/LRA.S240753

Ferre, F., Martin, C., Bosch, L., Kurrek, M., Lairez, O., & Minville, V. (2020b). Control of spinal anesthesia-induced hypotension in adults. In Local and Regional Anesthesia (Vol. 13, pp. 39–46). Dove Medical Press Ltd. https://doi.org/10.2147/LRA.S240753

Forkin, K. T., C., E., & Nemergut. (2016). Anesthesiology (8th ed., Vol. 124, Issue 4). Albany Medical. https://doi.org/https://doi.org/10.1097/ALN.0000000000001020

Guarracino, F., & Bertini, P. (2022). Perioperative hypotension: causes and remedies. In Journal of Anesthesia, Analgesia and Critical Care (Vol. 2, Issue 1). BioMed Central Ltd. https://doi.org/10.1186/s44158-022-00045-8

Horejsek, J., Kunstyr, J., Michalek, P., & Porizka, M. (2022). Novel Methods for Predicting Fluid Responsiveness in Critically Ill Patients—A Narrative Review. Diagnostics, 12(2). https://doi.org/10.3390/diagnostics12020513

Jacob, M., Chappell, D., Hofmann-Kiefer, K., Helfen, T., Schuelke, A., Jacob, B., Burges, A., Conzen, P., & Rehm, M. (2012). The intravascular volume effect of Ringer’s lactate is below 20%: A prospective study in humans. Critical Care, 16(3). https://doi.org/10.1186/cc11344

James, M. F. M., & Dyer, R. A. (2018). Clinical Fluid Therapy in the Perioperative Setting. Cambridge University Press.

Karnina, R., Rahmadani, S., & Faruk, M. (2022). Incidence oWink, Jeroen; Bernadette T, m.d.; wouters, patrick f. 2019. “Effects of Thoracic Epidural Anesthesia Regulation and Cardiac.” Thoracic Epidural Anesthesia and the Heart Medical 130(3):472–91.f Hypotension, Bradycardia, and Post-operative Nausea. Open Access Macedonian Journal of Medical Sciences, 10(B), 1602–1606. https://doi.org/10.3889/oamjms.2022.9024

Kemenkes. (2023). Hipotensi. https://yankes.kemkes.go.id/view_artikel/2324/hipotensi

Kemp, M. E. A. (2020). Crystalloids and colloids. Southern African Journal of Anaesthesia and Analgesia, 26(6), S80–S85. https://doi.org/10.36303/SAJAA.2020.26.6.S3.2544

Khosravi, F., Alishahi, M., Khanchemehr, Y., & Jarineshin, H. (2019). A Comparison Between the Effects of Preloading with Ringer’s Solution and Voluven on Hemodynamic Changes in Patients Undergoing Elective Cesarean Section Under Spinal Anesthesia. Medical Archives (Sarajevo, Bosnia and Herzegovina), 73(1), 44–48. https://doi.org/10.5455/medarh.2019.73.44-48

Maheshwari, K., & Sessler, D. I. (2020). Goal-directed Therapy: Why Benefit Remains Uncertain. Anesthesiology, 133(1), 5–7. https://doi.org/10.1097/ALN.0000000000003337

Malbrai, M. (2020). Intravenous fluid therapy in the perioperative and critical care setting: Executive summary of the International Fluid Academy (IFA). In Annals of Intensive Care (Vol. 10, Issue 1). Springer. https://doi.org/10.1186/s13613-020-00679-3

Mane, A. S. (2017). Fluid Resuscitation: Ringer Lactate Versus Normal Saline-A clinical Study. International Journal of Contemporary Medical Research, 4(11), 2454–7379.

Martin, N. D., Codner, P., Greene, W., Brasel, K., & Michetti, C. (2020). Contemporary hemodynamic monitoring, fluid responsiveness, volume optimization, and endpoints of resuscitation: An AAST critical care committee clinical consensus. Trauma Surgery and Acute Care Open, 5(1), 1–5. https://doi.org/10.1136/tsaco-2019-000411

Miller, T. E., & Myles, P. S. (2019). Perioperative Fluid Therapy for Major Surgery. Anesthesiology, 130(5), 825–832. https://doi.org/10.1097/ALN.0000000000002603

Morgan, & Mikhail’s. (2022). Clinical Anesthesiology (7, Ed.). Mc Graw Hill Lange.

Najm, Dr. E. S., Fadhil, Dr. A. A., & Shibli Younis, Dr. R. M. (2023). The Effect of Fluid Preloading on the Incidence of Hypotension During Spinal Anesthesia. Journal of Prevention, Diagnosis and Management of Human Diseases, 34, 26–35. https://doi.org/10.55529/jpdmhd.34.26.35

Neuman, M. D., Sieber, F., & Dillane, D. (2023). Comparative Effectiveness Research on Spinal versus General Anesthesia for Surgery in Older Adults. Anesthesiology, 139(2), 211–223. https://doi.org/10.1097/ALN.0000000000004604

Niazi, A., & Matava, C. (2019). Anesthesia for Medical Students (3rd ed.). University Of Toronto.

O’Rourke, K., Morrison, B., Sen, S., & Jones, C. (2019). Fluid management for enhanced recovery surgery. Digestive Medicine Research, 2(2), 37–37. https://doi.org/10.21037/dmr.2019.09.05

Perel, A. (2020). Using Dynamic Variables to Guide Perioperative Fluid Management. Anesthesiology, 133(4), 929–935. https://doi.org/10.1097/ALN.0000000000003408

Quarshie, A., Anno, A., Djagbletey, R., Sarpong, P., Sottie, D., Phillips, B. J., Lassey, P. D., Aryee, G., Essuman, R., & Owusu Darkwa, E. (2023). Comparison of Crystalloid Preloading and Coloading for Prevention of Spinal-induced Hypotension in Cesarean Delivery: A Randomized Controlled Trial at a Tertiary Facility in Ghana. Open Access Macedonian Journal of Medical Sciences, 11(B), 627–633. https://doi.org/10.3889/oamjms.2023.11657

Rijs, K., Mercier, F. J., Lucas, D. N., Rossaint, R., Klimek, M., & Heesen, M. (2020). Fluid loading therapy to prevent spinal hypotension in women undergoing elective caesarean section: Network meta-analysis, trial sequential analysis and meta-regression. European Journal of Anaesthesiology, 37(12), 1126–1142. https://doi.org/10.1097/EJA.0000000000001371

Sathyavrdhan, G. S., & Kamath, S. S. (2024). Crystalloid Preloading versus Prophylactic Ephedrine Infusion for Prevention of Hypotension during Caesarean Section. Journal of Obstetric Anaesthesia and Critical Care, 14(1), 33–36. https://doi.org/10.4103/JOACC.JOACC_29_23

Stickel, S., Gin-Sing, W., Wagenaar, M., & Gibbs, J. S. R. (2019). The practical management of fluid retention in adults with right heart failure due to pulmonary arterial hypertension. European Heart Journal, Supplement, 21, K46–K53. https://doi.org/10.1093/eurheartj/suz207

Tiruneh, A., Kibret, S., & Abrar, M. (2021). Crystalloid Fluid Pre-loading or Co-loading for Prevention of Spinal Anesthesia Induced Hypotension at Gandhi Memorial Hospital, 2016 Addis Ababa, Ethiopia: Comparative Cohort Study. Journal of Surgery and Anesthesia 1 J Surg Anesth, 5(2), 143.

Valverde, A. (2021). Fluid Resuscitation for Refractory Hypotension. Frontiers in Veterinary Science, 8(March), 1–12. https://doi.org/10.3389/fvets.2021.621696

Wink, J. B. T. m. d. ; wouters, patrick f. (2019). Effects of Thoracic Epidural Anesthesia Regulation and Cardiac. Thoracic Epidural Anesthesia and the Heart Medical, 130(3), 472–491.

Wu, J., Nie, J., Wang, Y., Zhang, Y., Wu, D., & Osemene, I. N. (2020). Relationship between saline infusion and blood pressure variability in non-critically patients with hypertension: A retrospective study. Medicine (United States), 99(35), 1–6. https://doi.org/10.1097/MD.0000000000021468