ABSTRACT
Physiologic is aimost associated with progressive loss of reserve in organ function. The objective of this study was to evaluate fluid preloading either by colloid, crystalloid or both on the incidence and frequency of spinal anesthesia induced hypotension in elderly patient. 60 patients scheduled for lower limb orthopedic surgery under spinal anaesthesia were randomly allocated to receive preload with either 6% hydroxyethyl starch 500 ml [Colloid group], 1000 ml lactated Ringer's [Crystalloid group], 500 mI lactated Ringer's plus 250 ml 6% hydroxyethylstarch [Combined group] or received no prehydration [No preload group]. ABP decreased significantly in the four groups after induction of spinal anaesthesia and it was significantly higher in the colloid goup than the other groups. The mean of ephedrine and incidence of hypotension was significantly lower in colloid group 3 of 15 [20%], compared with crystalloid 9 of 15 [60%], combined group 7 of 15 [46%] and no preload group 11 of 15 [73%]. intravascular administration in the four groups resulted in significant increase of CVP then decrease after spinal block. The use of colloid as a pre-emptive infusion is demonstrably effective to attenuate spinal anaesthesia induced hypotension in elderly patient as compared with crystalloid or no fluid preload. However, the incidence of hypotension was only reduced but not completely eliminated