Pre-procedural Intravenous Lactated Ringer’s Solution Preloading to Prevent Hypotension during Sedation for Elective Colonoscopy
Dujduen Sriramatr MD*, Paravee Bannakiat MD*, Chaiyapruk Kusumaphanyo MD*
Affiliation : * Department of Anesthesiology, Faculty of Medicine, Srinakharinwirot University, Nakhon Nayok, Thailand
Objective : Colonoscopy is a common procedure for diagnostic, therapeutic or surveillance purposes. Pre-procedural fasting
and bowel preparation to facilitate the procedure may result in dehydration, which could lead to hypotension during colonoscopy
under sedation. The goal of this study is to test the hypothesis that pre-procedural intravenous lactated Ringer’s solution (LRS)
preloading decreases the incidence of intra-procedural hypotension during sedation for elective colonoscopy.
Material and Method: Sixty ASA 1 to 2 Patients, aged 18 to 60 years presenting for elective colonoscopy were randomized
into 2 groups, control (C group) or preloading group (L group). Before procedure, C group received intravenous LRS of 1
hour maintenance while L group received intravenous LRS 200 ml preloading in 15 minutes prior to colonoscopy. Sedation
was achieved by intravenous fentanyl 25 mcg and propofol infusion using target-control infusor (TCI) with preset target of
propofol blood level 3.5 to 6 mcg/ml. Primary outcome was the incidence of hypotension, defined as >25% decrease in systolic
blood pressure from baseline during sedation. Secondary outcome were vasopressor use and post-procedural complications
(nausea, vomiting and dizziness).
Results : Fifty-three patients, 28 in C group and 25 in L group, completed the study. The incidence of hypotension were
39.3% in C group and 40.0% in L group (p = 0.958). Vasopressor use and post-procedural complications were either not
significantly different between groups.
Conclusion : Pre-procedural intravenous LRS 200 ml preloading cannot prevent hypotension during sedation for elective
colonoscopy in ASA 1 to 2 patients.
Keywords : Intravenous fluid, Preloading, Hypotension, Colonoscopy, Elective colonoscopy
