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British Journal of Anaesthesia, 2001, Vol. 87, No. 3 406-414
© 2001 The Board of Management and Trustees of the British Journal of Anaesthesia

Clinical Investigations

Volume kinetics of Ringer’s solution during induction of spinal and general anaesthesia

C.-A. Ewaldsson and R. G. Hahn*

Karolinska Institute, Department of Anaesthesia, Söder Hospital, S-118 83 Stockholm, Sweden*Corresponding author

The kinetics of an i.v. infusion of 20 ml kg–1 of Ringer’s solution over 60 min was studied in patients undergoing spinal (n=10) and general (n=10) anaesthesia. The induction resulted in similar changes in volume kinetic parameters in both groups. When a one-volume model was employed (n=8), however, the infusion expanded a smaller body fluid space in the four patients who had received preoperative enteric lavage (3.3 vs 8.3 litres), which is consistent with hypovolaemia. When a two-volume model was statistically justified (n=12), the induction reduced the rate of fluid equilibration between a fairly small central (V1, mean 1.4 litres) and a peripheral body fluid space by about 50% (P<0.01). The kinetic analysis suggested that a rapid fluid load of 350 ml given over 2 min just after the induction could possibly prevent arterial hypotension because of central hypovolaemia. This was confirmed in five additional patients.

Br J Anaesth 2001; 87: 406–14


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