Preoperative fasting can evoke a hypovolemia which may cause a hemodynamic instability during introduction of anesthesia. The purpose of this study is to test the hypothesis that a defined preoperative volume substitution compared to standard procedure will result in a reduced incidence of hemodynamic instabilities during introduction of anesthesia in elective surgery patients.
The preoperative fasting period often lasts longer than 2 hours as recommended by various national and international anesthetic guidelines. Thus, hypovolemia is more often then anticipated. In awake patients this condition is often masked. Introduction of anesthesia often leads to an unmasking of hypovolemia with a consecutive hemodynamic instability. Aim of the study is to test the hypothesis that a preoperative volume substitution (8 ml/kg RingerAcetate Solution in 15 min. prior to introduction of anesthesia) reduces possible hemodynamic instabilities during initiation of anesthesia.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Enrollment
220
University Hospital of Marburg, Department of Anesthesia
Marburg, Germany
hemodynamic instability
Hemodynamic instability during induction of anesthesia (0-10 min), defined as at least one of the following: * Systolic blood pressure \< 80 mmHg or decrease of 20% in preexistent hypertension * Mean blood pressure \< 50 mmHg or decrease of 20% or \> 20 mmHg in preexistent hypertension * Bradycardia \< 45/min or decrease of 20% in preexistent bradycardia \< 60/min. * Tachycardia \> 120/min * Cardiac index \< 2.0 l/min/m²
Time frame: at time of introduction of anesthesia
Stroke volume index > 35 ml/m2
Time frame: at time of anesthesia
Stroke volume variation < 12 %
Time frame: at time of anesthesia
Enddiastolic area (EDA) > 10 cm2
transthoracic echocardiographic parasternal short axis enddiastolic area
Time frame: at time of anesthesia
inferior vana cava diameter (VCI) > 15 mm
transthoracic echocardiographic inferior vena cava diameter
Time frame: at time of anesthesia
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