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Bolus Ringer’s Acetate Is Effective In Preventing Hypotension Following Lower Limb Tourniquet Release

Divya Teja Reddy, Junior Resident, Department of Anesthesiology, Bharatividyapeeth Medical College Pune, Maharashtra 411030, India. , Divyatejareddy1 , ShubhadaAphale2

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Indian Journal of Anesthesia and Analgesia 8(3):p 391-395, May-June 2021. | DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.8321.55

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Divyatejareddy, ShubhadaAphale/Bolus Ringer’s Acetate is Effective in Preventing Hypotension Following Lower Limb Tourniquet Release/Indian J Anesth Analg. 2021;8(3):391-395.

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Abstract

Background: Haemodynamic instability is a common entity following tourniquet release exacerbated by old age and comorbidities. Aim: To evaluate efficacy of bolus Ringer’s acetate in preventing hypotension following tourniquet release. Methods: After ethical committee’s approval, a comparative study was conducted in tertiary care hospital. Study was conducted on 80 consenting patients, control (n=40) and study (n=40) group between 20-80 years of age belonging to American Society of Anaesthesiologist (ASA)Grade I-II undergoing lower limb surgeries. Patients were divided into two equal groups, Group C patients did not receive bolus of Ringer’s acetate and Group S were given additional bolus of 200 ml of Ringer’s acetate prior to tourniquet release. Haemodynamic variables (heart rate (HR), Systolic, Diastolic and Mean arterial pressures, Electrocardiogram (ECG)) were monitored before and after release of tourniquet at frequent intervals. Hypotensive episodes (Fall in systolic blood pressure (SBP) >20% from baseline) and vasopressor requirement (If SBP <80mmHg then Inj. Ephedrine IV 5 mg) were noted. Results: Statistical analysis was done using Chi-Square test and independent sample t test. Intergroup comparison of haemodynamic variables before and after release of tourniquet is comparable and is not statistically significant. Intragroup comparison of haemodynamic variables in Group C was lower when compared to Group S after release of tourniquet and this finding is statistically significant. The incidence of hypotension and vasopressor requirement was significantly higher in Group C compared to Group S (Pvalue<0.029). Conclusion: Preloading with Ringer’s acetate prior to tourniquet release in Group S may possibly be responsible for reduction in incidence of hypotension and vasopressor requirement.

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Divyatejareddy, ShubhadaAphale/Bolus Ringer’s Acetate is Effective in Preventing Hypotension Following Lower Limb Tourniquet Release/Indian J Anesth Analg. 2021;8(3):391-395.

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DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.8321.55

Keywords

Ringer’s acetate; Hypotension; Tourniquet.

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