Volume kinetics of Ringer’s solution and dextran 3% during induction of spinal anaesthesia for Caesarean section

Reports of Investigation

Abstract

Purpose

To study how the body handles fluid given intravenously during the onset of spinal anaesthesia in women scheduled for Caesarean section.

Methods

The effect of spinal anaesthesia on the volume kinetics of a constant-rate infusion of 25 ml · kg−1 of Ringer’s solution (n = 11) and 10 ml · kg−1 of dextran 3% 60 (n = 8) was studied before elective Caesarean section, Measurements of the blood haemoglobin concentration and urine excretion served as input variables in calculations of the size(s) of the body fluid spaces expanded by the infused fluid. The blood glucose level was also monitored.

Results

When a one-volume kinetic model were fitted to the data, spinal anaesthesia reduced the size of the expanded body fluid space by 30% (Ringer’s) and 58% (dextran) (P < 0.02) When a two-volume model was statistically justified, anaesthesia reduced the rate of fluid equilibration between the two expanded body fluid spaces by 47% and 19%, respectively (P < 0.04) The baseline volume for the primary (central) fluid space was smaller than the expected plasma volume; 1.5 l for Ringer’s solution and 0.9 l for dextran. Only small changes in the blood glucose concentration were found.

Conclusion

The onset of spinal anaesthesia induces acute changes in the body’s handling of infused fluid that can be described by volume kinetic analysis.

Résumé

Objectif

Étudier le devenir des liquides administrés par voie intraveineuse durant l’induction de l’anesthésie rachidienne chez des parturientes subissant une césarienne.

Méthodes

Les effets de la rachianesthésie sur la cinétique volumétrique d’une infusion à débit constant de 25 ml · kg−1 de solution de Ringer (n= 11) ou de 10 ml · kg−1 de dextran 60 en solution à 3% (n = 8) ont été étudiés avant la césarienne élective. Les mesures du taux d’hémoglobine sanguin et du débit urinaire ont servi comme entrées variables dans le calcul de l’expansion volémique par le liquide infusé des différents compartiments corporels. La glycémie a aussi été mesurée.

Résultats

Lorsque les données étaient rapportées à un modèle cinétique à un seul compartiment, l’anesthésie rachidienne entraînait une réduction du compartiment corporel déjà distendu de 30% pour le Ringer et de 58% pour le dextran (P 0.02). Lorsqu’un modèle à deux compartiments apparaissait justifié d’un point de vue statistique, l’anesthésie entraînait une réduction du taux d’équilibration entre les deux compartiments corporels déjà distendus de 47% et de 19% respectivement (P 0.04). Le volume de base pour le compartiment primaire (central) était plus petit que le volume plasmatique prévu: 1.5L pour le Ringer et 0.9L pour le dextran. La glycémie a peu varié.

Conclusion

Linduction de l’anesthésie rachidienne entraîne des modification aiguës de la gestion par le corps humain des liquides infusés, ces modifications pouvant être décrites par des analyses de cinétique volumétrique.

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Copyright information

© Canadian Anesthesiologists 1998

Authors and Affiliations

  1. 1.Department of Anesthesia, Karolinska Institute, Department of AnaesthesiaSöder HospitalStockholmSweden

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