[Preventive treatment of hemodynamic disorders during conventional spinal anesthesia].
The prevention of blood pressure fall during a conventional spinal anaesthesia effected with 20 mg (4 ml) of isobaric 0.5 p. 100 bupivacaine relies on the use of vascular filling and/or a vasoconstrictor. A randomized prospective study was performed to evaluate the comparative efficacy of these two treatments. 148 patients were included and divided into three groups. Group I (n = 50): 2.5 mg IV bolus of etilefrine followed by continuous infusion (0.35 mg.kg-1.h-1). Group II (n = 50): 30 ml.kg-1 infusion of saline isotonic solution for 90 min, with infusion rate according to blood pressure. Group III (n = 48) did not receive any preventive treatment. A blood pressure fall of more than 30% of the initial value was observed in 59 patients: 18% of the etilefrine group, 28% of the saline infusion group, 54% of the control group. This peculiar frequency of hypotension in the control group emphasizes the need of a preventive treatment. Haemodynamic changes were fewer and less important in the etilefrine group compared with the saline infusion group. No failure and a better tolerance in the vasoconstrictor group were also to be noticed. These clinical data suggest that etilefrine could meet satisfactorily the therapeutic requirements.
Harti
A
A
Service d'Anesthésie-Réanimation, CH Ibn Rochd, Casablanca, Maroc.
Mjahed
K
K
Chlihi
A
A
Lamine
A
A
Laraki
M
M
Barrou
L
L
Ait Bahou
K
K
Benaguida
M
M
D000775:Anesthesia, Spinal / Q000009:adverse effects*; D005039:Etilefrine / Q000627:therapeutic use*; D006801:Humans; D007022:Hypotension / Q000209:etiology* / Q000517:prevention & control; D008875:Middle Aged; D011446:Prospective Studies; D012965:Sodium Chloride / Q000008:administration & dosage*; D013514:Surgical Procedures, Operative
D012965:Sodium Chloride; D005039:Etilefrine
Traitement préventif des perturbations hémodynamiques au cours de la rachianesthésie conventionannelle.