Abstract

To compare the haemodynamic and peripheral arterial oxygen saturation (SpO₂) variability  among three groups, i.e. no preload, 3.5% polygeline preload and Ringer’s lactate preload, after preloading and following spinal anaesthesia, in elective lower abdominal or lower limb surgery involving minimal blood loss in an adult non-parturient population.
Material and Methods: In a double-blind clinical trial, 75 ASA-I and ASA-II non-parturient adult patients undergoing elective lower abdominal or lower limb surgery were randomly allocated to three groups of 25 patients each, to receive either no preload, 3.5% polygeline solution (10 mLkg^-1), or Ringer’s lactate solution (20 mLkg^-1), as a preload before spinal anaesthesia. Serial measurements of the haemodynamic parameters (such as the heart rate, systolic arterial pressure and mean arterial pressure) and the peripheral arterial oxygen saturation were compared on inter-group and intra-group basis, after preloading and following spinal anaesthesia.
Results: The SAP and MAP was significantly higher (P≤0.05) in the polygeline and Ringer’s lactate groups, than in the no-preload group, after preloading, and following spinal anaesthesia (for a sustained duration in the polygeline group, and for a transitory duration in the Ringer’s lactate group). The SAP and MAP in the polygeline group remained significantly higher (P≤0.05)   than in the Ringer’s lactate group for only intermittent short durations with no significant difference either after preloading or from 1-13 minutes following spinal anaesthesia.  The difference in the incidence of spinal-induced hypotension (SIH) between the no-preload   (68%), polygeline (24%) and Ringer’s lactate (32%) groups was significant (P=0.003), with no significant difference between the polygeline and Ringer’s lactate groups (P=0.529). The SpO₂ in the polygeline and Ringer’s lactate groups remained significantly higher than in the control group, after preloading (P≤0.05) and following spinal anaesthesia (P=0.000), with no significant difference between the polygeline and Ringer’s lactate groups either after preloading or from 1 to 60 minutes following spinal anaesthesia.
Conclusion: The polygeline and Ringer’s lactate preload compared to a no-preload  maintained better haemodynamics and peripheral arterial oxygen saturation, after preloading and following spinal anesthesia, and reduced the incidence of SIH. There was no definite advantage of a polygeline preload over a Ringer’s lactate preload