Effects of Gelatin vs. Hydroxyethyl Starch Before Spinal Anaesthesia

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Journal name: The Malaysian Journal of Medical Sciences
Original article title: Comparing the Effects of Pre-loading with Gelatine 4% Plasma Volume Expander and 6% Hydroxyethyl Starch Solution Before Spinal Anaesthesia for Lower Limb Orthopaedic Surgery
The Malaysian Journal of Medical Sciences (MJMS) is a peer-reviewed, open-access journal published online at least six times a year. It covers all aspects of medical sciences and prioritizes high-quality research.
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Original source:

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Author:

Nur Dyana Md Nizar, Shamsul Kamalrujan Hassan, Rhendra Hardy Mohamad Zaini, Mohamad Hasyizan Hassan, Wan Mohd Nazaruddin Wan Hassan, Mohd Zulfakar Mazlan


The Malaysian Journal of Medical Sciences:

(A peer-reviewed, open-access journal)

Full text available for: Comparing the Effects of Pre-loading with Gelatine 4% Plasma Volume Expander and 6% Hydroxyethyl Starch Solution Before Spinal Anaesthesia for Lower Limb Orthopaedic Surgery

Year: 2020 | Doi: 10.21315/mjms2020.27.6.7

Copyright (license): CC BY 4.0


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Summary of article contents:

Introduction

Hypotension is a frequent complication that arises after spinal anaesthesia, particularly in lower limb orthopaedic surgery. Preventative measures often involve administering intravenous fluids prior to the spinal anaesthesia, a process referred to as pre-loading. However, the effectiveness and suitability of different fluids for this purpose remain topics of debate in the medical community. The study at hand aimed to compare the effects of two colloid pre-loading fluids—Gelaspan 4% and Volulyte 6%—to determine their impact on hypotension during spinal anaesthesia.

Effectiveness of Pre-loading Fluids

Despite administering 500 mL of either Gelaspan or Volulyte prior to spinal anaesthesia, both fluids were unable to prevent significant reductions in systolic blood pressure (SBP), diastolic blood pressure (DBP), and mean arterial pressure (MAP). Measurements indicated appreciable hypotension, with a significant drop observed over time, especially noted at 30 minutes post-anaesthesia. Interestingly, neither fluid provided a meaningful difference in terms of ephedrine usage, which is often required to counteract hypotension. However, both solutions were beneficial in maintaining normal acid-base balance, and comparisons revealed that Gelaspan resulted in higher sodium and calcium concentration post-pre-load compared to Volulyte, attributed to their differing compositions.

Conclusion

In conclusion, the study highlights that neither Gelaspan 4% nor Volulyte 6% significantly mitigates the incidence of hypotension following spinal anaesthesia in the context of lower limb surgery. While both colloids are valuable for maintaining acid-base equilibrium, their overall effectiveness in preventing hypotension remains limited. This underscores the ongoing challenge in determining the ideal pre-loading fluid for spinal anaesthesia, necessitating further research to explore optimal fluid volumes and combinations to improve clinical outcomes.

FAQ section (important questions/answers):

What is the purpose of the study comparing Volulyte and Gelaspan?

The study aimed to compare the effects of Gelaspan 4% and Volulyte 6% as pre-loading fluids to prevent hypotension following spinal anaesthesia in patients undergoing lower limb orthopaedic surgery.

How many patients participated in the study and how were they selected?

A total of 93 patients, aged 18 to 60 years, with ASA physical status I or II, undergoing elective or emergency orthopaedic lower limb surgery were selected and randomized into two groups.

What significant findings were observed regarding blood pressure and heart rate?

Both Volulyte 6% and Gelaspan 4% pre-loading did not prevent significant reductions in blood pressure and heart rate after spinal anaesthesia, although they maintained normal acid-base balance.

What electrolyte changes were noted between the two pre-loading fluids used?

Post-preload sodium levels were significantly higher in the Gelaspan group, while the calcium concentration was significantly lower after pre-loading with Volulyte compared to Gelaspan.

Glossary definitions and references:

Scientific and Ayurvedic Glossary list for “Effects of Gelatin vs. Hydroxyethyl Starch Before Spinal Anaesthesia”. This list explains important keywords that occur in this article and links it to the glossary for a better understanding of that concept in the context of Ayurveda and other topics.

1) Table:
In academic writing, a 'table' is a systematic arrangement of data in rows and columns, allowing for clear comparison and analysis of variables. In medical studies, tables often present demographic data, patient outcomes, or statistical results, facilitating an understanding of the study's findings and interactions among variables.

2) Study (Studying):
A 'study' refers to a systematic investigation aimed at discovering new information or validating existing knowledge within a particular field. In medical research, studies may focus on treatment efficacy, disease prevention, or patient care strategies. They follow a structured methodology to yield reliable and scientifically valid results.

3) Post:
The term 'post' can refer to something occurring after a specific event, such as a medical procedure or treatment. In the context of the study, it often relates to post-operative conditions or evaluations following interventions. It signifies the importance of monitoring patient outcomes after surgical procedures.

4) Blood:
Blood is a vital fluid that circulates in the body, carrying oxygen, nutrients, and waste products. In medical studies, monitoring blood parameters, such as pressure or gas exchange, is essential for assessing physiological status and diagnosing health conditions. Blood analysis is crucial for evaluating treatment effects and complications.

5) Rules:
Rules in the context of a study refer to the prescribed guidelines that govern the methodology, data collection, and interpretation processes. They ensure the reliability and validity of findings. Adhering to study rules contributes to the ethical conduct of research, protecting participants and ensuring sound scientific practices.

6) Pulse:
Pulse refers to the rhythmic expansion and contraction of arteries as blood is pumped by the heart. Measurement of pulse is crucial in clinical settings as it reflects cardiovascular health and can indicate underlying health issues. Abnormal pulse rates can signal complications that require further medical evaluation.

7) Measurement:
Measurement in research refers to the process of quantitatively determining the characteristics or properties of specific variables. Accurate measurement is vital in studies, particularly in medicine, to assess outcomes, effectiveness of treatments, and physiological changes. It forms the foundation for data analysis and interpretation of results.

8) Jalandhara (Jalamdhara):
Jalandhara is likely a reference to an author or researcher whose work relates to a specific area of study, possibly in anesthesiology or fluids management. Recognizing contributions from individual researchers helps contextualize the study within existing literature, showcasing collaboration and advancements in medical knowledge and practices.

9) Maurya:
Similar to Jalandhara, Maurya denotes another author contributing to the study's findings or methodology. Acknowledging various authors helps in understanding the breadth of collaboration in scientific research, and reveals the diverse expertise involved in the exploration of clinical queries and treatments in the study presented.

10) Debate:
Debate in the context of medical research often refers to ongoing discussions about the best practices or treatment options, such as the choice between colloids and crystalloids for fluid management. Engaging in debate can facilitate further research and improvements in clinical guidelines, ultimately enhancing patient care.

11) Mitra:
Mitra is likely another significant contributor or author in the medical studies or findings referenced. Identifying authors allows for a clearer attribution of ideas, methodologies, and research outcomes. Such recognition is crucial for academic integrity and understanding the evolution of thoughts in medical contexts.

12) Vena:
Vena relates to blood vessels, specifically veins, which play a major role in circulation by returning deoxygenated blood to the heart. In medical literature, understanding the anatomy and function of venae is essential for procedures involving intravenous lines, fluid administration, and vascular assessments during surgeries and treatments.

13) Pain:
Pain is a fundamental concept in medicine, representing an unpleasant sensory and emotional experience often associated with tissue damage or disease. Addressing pain effectively is crucial for patient satisfaction and recovery, making pain management strategies a significant focus in clinical research and treatment protocols.

14) Discussion:
Discussion in research refers to the section where authors interpret their findings, compare them with existing literature, and suggest implications or future research avenues. This segment encapsulates the study's significance, helping readers understand the broader context and potential impact of the research findings on practice.

15) Vomiting:
Vomiting is a physiological response that expels contents from the stomach. It is often viewed as a symptom of underlying health issues, medication side effects, or complications following medical procedures. In studies on anesthesia or pain management, understanding and addressing vomiting is critical for improving patient care and outcomes.

16) Relative:
Relative often refers to relationships between variables or patient conditions in medical studies. This may include the relative risks or benefits of treatments or interventions. Understanding these relationships is essential for clinicians and researchers to make evidence-based decisions regarding patient management and treatment options.

17) Disease:
Disease represents a departure from health, characterized by specific symptoms or physiological changes. In research, categorizing and understanding diseases are crucial for developing effective treatment strategies and improving patient outcomes. It is essential for identifying potential complications in studies related to anesthesia and post-operative care.

18) Allergy:
Allergy refers to an immune response to substances considered harmless, leading to various symptoms ranging from mild to severe. Understanding allergies is critical in medical practice, particularly concerning medication administration, anesthesia, and surgical procedures. Studies often evaluate allergy prevalence and management strategies to enhance patient safety.

19) Nausea:
Nausea is a common symptom experienced by patients, often associated with treatment protocols or conditions such as anesthesia. Evaluating nausea's incidence and management is critical in improving post-operative care and patient satisfaction. It reflects the importance of patient comfort during the recovery process after medical interventions.

20) Sign:
Sign refers to an observable indication of a condition or disease. In a clinical context, identifying signs aids in diagnosing and managing health conditions. Research studies often focus on significant signs and their implications for prognosis, treatment decisions, and overall patient care.

21) Hand:
In medical studies, 'hand' may refer to surgical methods or assessments involving manual dexterity or techniques. Understanding hand functions' role in procedures is crucial for developing surgical skills and improving patient outcomes, particularly in fields like orthopaedic surgery and anesthesiology, where precise techniques are essential.

22) Burning (Burn, Burned, Burnt):
Burns refer to tissue injuries caused by heat, chemicals, electricity, or radiation, leading to significant pain and requiring critical care. In medical research, understanding burn treatment protocols and their implications is vital for optimizing patient recovery and reducing complications, emphasizing the need for comprehensive wound management strategies.

23) Drug:
Drug refers to any substance used for diagnosis, treatment, or prevention of disease, including medications administered during surgeries. In medical research, understanding drug efficacy, dosage, and interactions are critical to ensuring safe and effective patient care, particularly in pharmacological studies related to anesthesia and pain management.

24) Male:
Male denotes one of the two primary biological sexes and is often used in medical studies to identify differences in health outcomes, treatment responses, or disease prevalence between sexes. Recognizing male representation helps in understanding the impact of sex on medical findings and patient care decisions.

Other Health Sciences Concepts:

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Discover the significance of concepts within the article: ‘Effects of Gelatin vs. Hydroxyethyl Starch Before Spinal Anaesthesia’. Further sources in the context of Health Sciences might help you critically compare this page with similair documents:

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