The study, conducted by researchers at the Hyogo College of Medicine in Japan, examined sixty ASA physical status I/II patients undergoing tympanoplasty. The patients fasted from midnight. Anesthesia was induced by fentanyl, and propofol was maintained with sevoflurance and remifentanil. Coinciding with the induction of anesthesia, 15 mL/kg acetated Ringer solution was infused IV for 60 minutes, followed by 1 mL/kg acetated Ringer solution for the next 30 minutes.
Urine osmolalities were measured after induction of anesthesia and during the study period. Patients with a urine osmolality under the 25th percentile at anesthesia induction were categorized in the hydrated group, while patients with a urine osmolality above the 75th percentile at anesthesia induction were categorized in the dehydrated group. The dehydrated group and hydrated group did not show significant differences in hypotension magnitude.
According to the report, the results of the study suggest that intravascular volume loading with crystalloid solution to prevent hypotension during general anesthesia is an unfounded practice for low-risk patients after overnight fasting.
Read the abstract on the study in Anesthesia & Analgesia.
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