A comparison of three fluid-vasopressor regimens used to prevent hypotension during subarachnoid anaesthesia in the elderly

JCM Yap, LAH Critchley*, SC Yu, RM Calcroft, JL Derrick

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

18 Citations (Scopus)


We aimed to compare the efficacy of fluid preloading with two recently recommended fluid-vasopressor regimens for maintaining blood pressure during subarachnoid anaesthesia in the elderly. Sixty elderly patients requiring surgery for traumatic hip fractures received subarachnoid anaesthesia using 0.05 ml/kg of 0.5% heavy bupivacaine. Hypotension, i.e. systolic arterial pressure <75% of baseline, was prevented or treated by: A- normal saline 26 ml/kg plus intravenous ephedrine boluses (0.2 mg/kg); B-normal saline 8 ml/kg plus intramuscular depot ephedrine (0.5 mg/kg); or C-Haemaccel 8 ml/kg plus metaraminol infusion. Systolic arterial pressure and heart rate were recorded using custom-written computer software (Monitor; version 1.0).

Systolic arterial pressure den eased in all groups after five minutes (P

We conclude that treatment A was inadequate in preventing hypotension. Treatments B and C were more effective but were associated with an increased heart rate and overcorrection of systolic arterial pressure respectively.

Original languageEnglish
Article number3
Pages (from-to)497-502
Number of pages6
JournalAnaesthesia and Intensive Care
Issue number5
Publication statusPublished - Oct 1998
Externally publishedYes


  • anaesthesia : subarachnoid, spinal
  • vasopressor : ephedrine, metaraminol
  • complications : hypotension

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