A comparative study of three different methods of administering metaraminol during spinal anaesthesia in the elderly

Anaesthesia and Intensive Care
L A Critchley, S C Yu

Abstract

We compared three methods of administering metaraminol during spinal (subarachnoid) anaesthesia. Fifty-two elderly patients with fractured hips were studied. Blood pressure was maintained by either intramuscular (i.m.) metaraminol (0.1 mg x kg(-1)), intravenous (i.v.) boluses (0.01 mg x kg(-1)) or an infusion (0.05 mg x kg(-1) x h(-1)). Non-invasive blood pressure was recorded every one-minute. Spinal anaesthesia initially decreased the systolic arterial pressure by 15 (14) % compared to 35 (15) % for diastolic pressure (P<0.001). I.m. metaraminol restored the systolic arterial pressure back to baseline values (-3%), but there was significant between-subject variability resulting in a very unpredictable effect. I.v. boluses and infusion had a more predictable effect and maintained systolic arterial pressure at about 20% below baseline. Range of effect, measured by inter-quartile range and variance, was greatest in the i.m. group and least in the infusion group (P<0.003). I.m. metaraminol during spinal anaesthesia has a very unpredictable effect. Infusions of metaraminol provided the best blood pressure control. Diastolic blood pressure fell significantly after spinal anaesthesia and this merits further investigation.

References

Jan 1, 1978·Acta Anaesthesiologica Scandinavica·H HilkeE Syvälahti
Sep 1, 1995·British Journal of Anaesthesia·R JacksonJ Thorburn
Apr 1, 1995·British Journal of Anaesthesia·L A CritchleyT G Short
Oct 1, 1994·British Journal of Anaesthesia·L A CritchleyT Gin
May 1, 1995·British Journal of Anaesthesia·J E SternloR Sandin
May 1, 1994·Canadian Journal of Anaesthesia = Journal Canadien D'anesthésie·P Morgan
Feb 1, 1994·British Journal of Anaesthesia·L A CritchleyT Gin
Oct 1, 1993·British Journal of Anaesthesia·C S Reilly
Jun 1, 1993·British Journal of Anaesthesia·A F McCrae, J A Wildsmith
May 1, 1996·British Journal of Anaesthesia·L A Critchley, F Conway
Dec 1, 1996·Anaesthesia·L A Critchley

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Citations

Aug 27, 2005·Human & Experimental Toxicology·D M WoodP I Dargan
Oct 30, 2003·The Medical Journal of Australia·Michael N ChilovUNKNOWN Australian National Health and Medical Research Council

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