Effect of Preload on Bladder Retention Volume During Spinal Anesthesia
Condition: Diuresis; Bladder Retention Volume; Hypotension
MeSH terms: Urinary Retention; Hypotension
Study type: Interventional

Summary: 
      The purpose of this study is to assess the influence of different fluid infusions on the
      quantity of bladder retention after spinal anesthesia. This study should determine if this
      increase in bladder retention is significant and relevant.
    

Detailed description: 
      Background of the study:

      Spinal anesthesia , through interruption of spinal nerve conduction, causes intense blockade
      of sensation, motor function as well as (para)sympathetic function. Loss of sympathetic tone
      causes vasodilation which may lead to arterial hypotension and bradycardia. To avoid these
      effects, in anesthetic practice, usually intravenouspreload is administered as cristalloids
      or colloids. The form and dosage of these plasma expanders will influence diuresis during
      spinal anesthesia-induced detrusor blockade. Excess diuresis may cause bladder distension and
      neccecitates bladder catheterization

      Objective of the study:

      To compare the quantitative effects of Ringer Lactate and HES 6% on diuresis during spinal
      anesthesia-induced detrusor blockade as well as prevention of hypotension and vasopressor
      use.

      Study design:

      Before spinal anesthesia is performed, patients are randomized into one of the 3 study groups
      (no preload, preload with Ringers' Lactate 14 ml/kg, preload with HES 6% 7 ml/kg). Spinal
      anesthesia is administerd with lidocaine 2% 70mg. Hypotension is treated with vasopressors,
      atropine or additional intravenous fluid. Bladder scans will be performed on the recovery
      unit and day-case unit. Total urinary volume is measured until sensory function at dermatome
      S2/3 is restored and spontanous voiding is possible.

      Study population:

      ASA 1-2 patients who present for spinal anesthesia for minor surgery on the lower extremitiy.
      Age 18-60 years.

      Intervention (if applicable):

      Prespinal administration of intravenous Ringers' Lactate 14 ml/kg or HES 6% 7 ml/kg.

      Primary study parameters/outcome of the study:

      Primary outcome is total urinary volume during spinal induced detrusor blockade, and number
      of subjects that have a bladdder volume over 500ml.

      Secundary study parameters/outcome of the study (if applicable):

      Secondary outcome parameters:

      Periods of hypertension, and total dose of vasopressor en extra fluid administration.

      Nature and extent of the burden and risks associated with participation, benefit and group
      relatedness (if applicable):

      Except for extra bladderscan and block height measurements, all actions are part of routine
      anesthesiologic care.

      Ga naar boven
    

Intervention name(s): placebo; Ringers Lactate; HaemoHES 6%
Intervention type(s): Other; Drug; Drug
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Triple (Care Provider, Investigator, Outcomes Assessor)
Keywords: spinal anesthesia; preload; diuresis; bladder retention