This report tests the hypothesis that intravascular prehydration with 3% gelatin in electrolyte solution maintains arterial blood pressure after spinal anesthesia better than with an equal volume of isotonic saline solution. Thirty-four patients undergoing elective transurethral resection of the prostate were allocated randomly to receive either 7 mL/kg of isotonic saline 0.9% (17 patients) or 7 mL/kg of 3% gelatin in electrolyte solution (17 patients) before spinal anesthesia. There was a significant increase in central venous pressure in the gelatin group without any significant change in the isotonic saline group. After spinal anesthesia, the mean systolic blood pressure significantly decreased in both groups; however, the incidence of systolic blood pressure greater than 75% of control value was higher in the gelatin group (15/17) than in the normal saline group (9/17). Also, the mean dose of phenylephrine required to maintain arterial blood pressure > 75% of the baseline value was significantly larger in the normal saline group than in the gelatin group. We conclude that prophylactic administration of gelatin is more effective than saline in attenuating spinal anesthesia-induced hypotension.

Background:Pressure controlled ventilation (PCV) is the preferable mode of ventilation of nonparalyzed patients undergoing anesthesia with laryngeal mask airway (LMA) as compared to volume controlled ventilation (VCV) and spontaneously breathing patient. In this study, we compared the PC–volume guarantee (PC-VG) mode of ventilation with VCV and PCV modes.Materials and Methods:A total of 30 patients, American Society of Anesthesiologists (ASA) physical status Classes I and II, scheduled for elective surgery under general anesthesia with a classic LMA were ventilated, subsequently, with the three modes of ventilation: VCV, PCV, and PC-VG for 10 min each mode. Tidal volume set for all patients was 8 ml/kg of ideal body weight. Parameters measured with modes of ventilation include peak inspiratory pressure (PIP), compliance, measured tidal volume, O2 saturation, end-tidal CO2, and presence of an oropharyngeal leak.Results:The PIP was significantly higher with the application of VCV mode of ventilation than PCV and PC-VG modes. The compliance was significantly lower when using the mode of ventilation VCV than PCV and PC-VG. The PIP and the compliance were not statistically different between the PCV and PC-VG modes of ventilation.Conclusions:Ventilation of nonparalyzed patients with LMA under anesthesia with PC-VG is advantageous over VCV in reducing PIP and increasing lung compliance. No difference was noted between PCV and PC-VG in ASA Classes I or II under the adequate depth of anesthesia in patients with normal pulmonary function.

Thirty-three patients undergoing elective transurethral resection of the prostate were allocated randomly to receive either 0.9% isotonic saline 7 ml kg-1 (16 patients), or 3% hypertonic saline 7 ml kg-1 (17 patients) as a preload before spinal anaesthesia. After spinal anaesthesia, the incidence of systolic arterial pressure < 75% of control value was greater in the normal saline group than in the hypertonic saline group. Also, the mean dose of phenylephrine required to maintain arterial pressure > 75% of the baseline value was significantly greater in the normal saline group than in the hypertonic saline group.

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