DOI: http://dx.doi.org/10.18203/2349-2902.isj20195952

A comparative study of various types of intravenous fluids on the changes during induction of general anaesthesia

Surendra Kumar, Desh Pal Singh, Shailja Sharma, Praveen Kumar

Abstract


Background: The induction and endotracheal intubation is the most risky and initial process of general anaesthesia. Without induction and endotracheal tube placement one cannot imagine the general anaesthesia. Propofol and fentanyl are the commonly used drugs for induction of general anaesthesia. These drugs produce hypotension and other cardiorespiratory disturbances. These hazardous and sometimes fatal effects can be reduced and eliminated by preloading the patients with colloid or crystalloid solutions.

Methods: We selected 90 patients who visited our hospital in the last 2 years from June 2017 to May 2019. All the investigations and pre-anaesthetic check-up was done routinely. These patients had to undergo different surgical procedures under general anaesthesia. The induction of anaesthesia was done with propofol and fentanyl. These patients were divided in three groups A, B and C. Group A patients did not receive any preloading. Group B was given colloids (3.5% gelatins) and group C received crystalloids (Ringer’s lactate solution). The haemodynamic changes were noted and analysed statistically.

Results: The study showed that IV fluids given before induction of general anaesthesia blunts the adverse cardiovascular response.

Conclusions: We concluded that preload with fluids whether colloids or crystalloids are beneficial to counter the detrimental effects of propofol and fentanyl for induction of general anaesthesia. The preload fluids stabilise the patient haemodynamically. When compared the two, colloids were better to blunt the cardiovascular changes.

 


Keywords


Propofol, Fentanyl, Haemodynamic, General anaesthesia

Full Text:

PDF

References


Grounds RM, Twigley AJ, Carli F. The haemodynamic effects of thiopentone and propofol, Anaesthesia. 1985;40:735.

Al Khudain D, Cordon G, Morgan M. Acute Cardiovascular changes following di-isopropofol: Effect in heavily sedated patients with coronary artery disease, Anaesthesia. 1982;37:1007.

Patrick MR, Blair IJ Feneck RD. A comparison of haemodynamic effect of thiopentone in patients with coronary artery disease. Postgrad Med J. 1985;23:61.

Coats DP, Monk CR, Prys-Roberts C. Haemodynamic effects of infusion of the emulsion formulation of propofol during nitrous oxide anaesthesia in humans. Anaesth Analg. 1987;66:64.

Stanly TH, Webster LR. Anaesthetic requirements and cardiovascular effect of fentanyl-oxygen and fentanyl- diazepam oxygen anaesthesia in man. Anaesth Analg. 1978;57:411.

Lunn JK, Stanley TH, Webester LR. High dose fentanyl anaesthesia for coronary artery surgery: Plasma fentanyl concentration and influence of Nitrous Oxide on cardiovascular response. Anesth Analg. 1979;58(5):390-5.

Aun C, Major E. The cardio-respiratory effect of ICI 35, 868 in patients with valvular heart disease. Anaesthesia. 1984;39:1096-100.

Gill SS, Wright EM, Reilly CS. Pharmacokinetic interaction of propofol and fentanyl. Single bolus injection study. Br J Anaesth. 1990;65:760-5.

Cummings G, Dixon J, Kay NH. Dose requirement of propofol in a new formulation for induction of anaesthesia. Anaesthesia. 1984;39:1168-71.

Vohra A, Thomas AN, Harper NJN, Pollard BJ. Non-invasive measurement of cardiac output during induction of anaesthesia and tracheal intubation: thiopentone and propofol compared. BJA. 1991;67:64-8.

Wodey E, Chonow L, Beneux X, Azzis O, Bansard JY, Ecoffey C. Haemodynamic effect of propofol vs thiopental in in infants: an echocardiographic study. BJA.1999;82:516-20.

Williams JP, McArthur JD, Walker WE, Teunissen E, Reitesema K, Stanley TH. The cardiovascular effect of propofol in patients with impaired cardiac function. Anaesth Analg. 1986;65:589.

Kumar M, Saxena N and Saxena AK. The effect of a colloid or crystalloid preload on hypotension caused by induction of anesthesia with propofol and fentanyl. J Anesth Clin Pharmacol. 2008;24(4):409-12.

Perel P, Roberts I, Ker K. Colloids versus crystalloids for fluid resuscitation in critically ill patients. Cochrane Database Syst Rev 2013;2:CD000567.

Singh J, Ranjit S, Shrestha S, Sharma R, Marahatta SB. A study to investigate the effects of volume preload on changes of patient’s hemodynamic. Kathmandu Univ Med J. 2010;8(2):216-21.

Singh B, Singh AP, Bhardwaj A, Singh I. A Comparative study of preloading with ringer lactate v/s 6% hexa starch solutions to prevent hypotension following spinal anaesthesia in elective surgery. Into J Med and Dent Sci. 2016;5(2):1178-83.