British Journal of Anaesthesia, Vol 76, Issue 5 734-736, Copyright © 1996 by The Board of Management and Trustees of the British Journal of Anaesthesia
LAH. Critchley and F. Conway
We have studied 45 patients, aged 60-95 yr, receiving subarachnoid block
for neck of femur fractures. Patient received either colloid (polygeline,
Haemaccel) 8 ml kg-1 (n = 15), metaraminol 5 micrograms kg- 1 and 1.7
micrograms kg-1 min-1 (n = 15) or a combination of both treatments to
maintain systolic arterial pressure (SAP) between 75 and 100% of baseline.
If necessary, additional colloid 2 x 4 ml kg-1 or metaraminol 3 x 2.5
micrograms kg-1 was given. Arterial pressure was measured by automated
oscillotonometry, central venous pressure (CVP) by a manometer and cardiac
index (CI), stoke index (SI) and heart rate (HR) by transthoracic
electrical bioimpedance. Systemic vascular resistance index (SVRI) was
derived. Colloid was less effective than metaraminol (P < 0.05). In the
colloid group, SAP and SVRI decreased and CVP, CI and SI increased (P <
0.001). In the metaraminol group, initial decreases in SAP, SVRI and CVP
were restored after 10-15 min and HR decreased after 12 min (P < 0.001).
In the combined group, initial decreases in SAP and SVRI were restored
after 4 and 16 min, and CVP, CI, SI and HR increased (P < 0.001).
Metaraminol was more effective than colloid because it increased SVRI,
whereas colloid increased CVP without significantly increasing CI.
SHORT COMMUNICATIONS
Hypotension during subarachnoid anaesthesia: haemodynamic effects of colloid and metaraminol
Department of Anaesthesia and Intensive Care, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong
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