title: A randomized-controlled trial of high- or low-volume intravenous Plasma-Lyte(®) to prevent hypotension during sedation for colonoscopy.
abstract: OBJECTIVE
  The purpose of this study was to compare the incidence of hypotension during sedation in adults presenting for elective colonoscopy and randomized to intravenous Plasma-Lyte 148(®) at either 2 mL·kg(-1) (low volume) or 20 mL·kg(-1) (high volume).
  
  
  METHODS
  Patients aged ≥ 18 yr presenting for elective colonoscopy, with or without gastroscopy, after oral bowel preparation were randomized to receive the intervention immediately before the start of the procedure. Hypotension was defined as a ≥ 25% decrease in systolic blood pressure (SBP) from baseline during the procedure. Secondary outcomes included SBP < 90 mmHg, lowest SBP during sedation, duration of hypotension, use of vasopressors, postoperative outcomes, and cost.
  
  
  RESULTS
  Seventy-five patients were randomly allocated to either the low-volume or high-volume group, respectively (total n = 150). The incidence of hypotension was similar in the two groups (59% vs 56%, respectively; odds ratio, 0.90; 95% confidence interval, 0.47 to 1.71; P = 0.74). The incidence of SBP < 90 mmHg, the lowest SBP during sedation, the duration of hypotension, the use of vasopressors, and postoperative outcomes were also similar in the two groups.
  
  
  CONCLUSIONS
  This study does not support the routine use of 20 mL·kg(-1) of intravenous Plasma-Lyte 148 to prevent hypotension and other complications during sedation for elective colonoscopy in adult patients. Clinical Trials Registry (ANZCTR 12615001288516).
authors.affiliation: Department of Anaesthesia and Pain Management, Royal Melbourne Hospital, Melbourne, Australia. kate.leslie@mh.org.au.|Anaesthesia, Perioperative and Pain Medicine Unit, University of Melbourne, Melbourne, Australia. kate.leslie@mh.org.au.|Department of Pharmacology and Therapeutics, University of Melbourne, Melbourne, Australia. kate.leslie@mh.org.au.|Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia. kate.leslie@mh.org.au.
authors.forename: Kate
authors.initials: K
authors.lastname: Leslie
authors.affiliation: Department of Anaesthesia and Pain Management, Royal Melbourne Hospital, Melbourne, Australia.|Anaesthesia, Perioperative and Pain Medicine Unit, University of Melbourne, Melbourne, Australia.
authors.forename: Megan
authors.initials: M
authors.lastname: Allen
authors.affiliation: Department of Anaesthesia and Pain Management, Royal Melbourne Hospital, Melbourne, Australia.|Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia.
authors.forename: Austin
authors.initials: A
authors.lastname: Lee
authors.affiliation: Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia.|Melbourne Institute of Applied Economics and Social Research, University of Melbourne, Melbourne, Australia.
authors.forename: Phillip
authors.initials: P
authors.lastname: Clarke
mesh_terms: D000328:Adult; D000368:Aged; D000758:Anesthesia / Q000009:adverse effects*; D001794:Blood Pressure / Q000187:drug effects; D003113:Colonoscopy; D004305:Dose-Response Relationship, Drug; D004311:Double-Blind Method; D005260:Female; D005942:Gluconates / Q000008:administration & dosage / Q000627:therapeutic use; D006801:Humans; D007022:Hypotension / Q000517:prevention & control*; D015636:Magnesium Chloride / Q000008:administration & dosage / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D011189:Potassium Chloride / Q000008:administration & dosage / Q000627:therapeutic use; D019346:Sodium Acetate / Q000008:administration & dosage / Q000627:therapeutic use; D012965:Sodium Chloride / Q000008:administration & dosage / Q000627:therapeutic use
chemical_list: D005942:Gluconates; C012499:Plasma-lyte 148; D015636:Magnesium Chloride; D012965:Sodium Chloride; D019346:Sodium Acetate; D011189:Potassium Chloride