Effect of different fluids on blood volume expansion in epidural anesthesia of elderly patients

Abstract

Relative hypovolemia is generally considered to be the cause of the reduction of the blood pressure during epidural anesthesia, especially in the elderly groups. In this study, we compared the effect of 6 % hydroxyethyl starch 130/0.3, succinyl gelatin and lactated Ringer's solution on blood volume expansion in epidural anesthesia of aging. Sixty ASA I-II elderly patients scheduled for elective radical mastectomy requiring epidural anesthesia were recruited. Patients were randomly assigned into three groups of infusing different fluid. An intravenous fluid load of 1,000 ml of 6 % hydroxyethyl starch 130/0 (group A), succinyl gelatin (group B) or lactated Ringer's solution (group C) was given at a constant rate over 60 min via an infusion pump. Intravenous 125I-HSA1 ml (5-10 lCi) was injected into the cubital vein of infusing fluid. The plasma volume, basis of blood volume, blood volume of different time, blood volume change and fluid remained were calculated from the equation. The incidence of hypotension was higher in group C than other two groups (P < 0.01). During the surgery, the systolic and diastolic blood pressure declined in all groups and the difference was significant in group A, B (P < 0.05) and group C (P < 0.01). The BV increased significantly 30 min after anesthesia to 60 min after completing infusing in all groups (P < 0.05). Compared with group C, ΔBV, FR increased significantly in group A and B from completing infusing to 60 min later (P < 0.05). 6 % hydroxyethyl starch 130/0.3 and succinyl gelatin are better to keep the hemodynamic stability in elder patients after performing epidural anesthesia and can last longer in the circulation. © Springer Science+Business Media Dordrecht 2014.