Comparison of the Effect of Prophylactic Ephedrin, Ringer’s Lactate, and Colloid Applied During Spinal Anaesthesia on Hemodynamic Parameters in Geriatric Patients

Objective: Spinal anesthesia, especially in the elderly population, may cause a range of problems from hypotension, cerebral ischemia and myocardial infarcts, to acute renal failure and cardiac arrest. In our study, we researched the effect of ephedrine, ringer lactate, and colloid solutions administered prophylactically on hemodynamic parameters in geriatric patients administered spinal anesthesia.
Methods: This prospective, randomized, double-blind study included 75 patients aged 65 years and older in the American Society of Anesthesiologists I-II risk group undergoing urogenital system surgery. Patients were randomly divided into 3 groups called R, C and E. Group R was administered 1000 mL ringer lactate + 2 mL 0.9% NaCl, group C were administered 500 mL hydroxyethyl starch solution, and group E were administered 1000 mL ringer lactate + 10 mg ephedrine (with 2 mL volume). All patients had 5 mL/kg/hr ringer lactate administered for maintenance. The patients’ systolic (SBP), diastolic (DBP) and mean blood pressure (MBP), heart rate (HR), and SpO2 data were recorded. The values before administering fluids were taken as control values and a 30% fall in systolic blood pressure or systolic blood pressure <90 mmHg was accepted as hypotension, and 5 mg IV ephedrine was administered.
Results: In all groups, the SBP, DBP, and MBP were identified to have statistically significant increases at prepuncture (PP) and intraoperative 5th minute (I5) times. In group C, the hemodynamic changes after the increase at PP and I5 were less for SBP, DBP and MBP compared to groups R and E. In terms of HR, only group R had a statistically significant fall. One case in group R had bradycardia was identified.
Conclusion: All three methods can be used safely in the geriatric population; however, we concluded that patients with colloid infusion had more stable hemodynamic parameters.