BackgroundWe studied the effect of crystalloid co-loading with simultaneous infusion of vasopressor phenylephrine on circulatory stability during general anaesthesia induction with propofol in ASA II/III patients. We analysed the postinduction phase because circulatory instability is most prevalent in this period and more prominent in multimorbid patients. Prevention rather than treatment might be a better strategy to avoid complications associated with even short periods of instability.Methods46 ASA II/III patients were randomly assigned to two treatment groups. During the induction, the control group received an infusion of phenylephrine only and the test group received the same phenylephrine regimen and also a crystalloid co-load. Cardiac index (CI), mean arterial pressure (MAP), stroke volume index (SVI), systemic vascular resistance index (SVRI), stroke volume variation (SVV) and heart rate (HR) were recorded for 18 minutes and the dynamics of change between groups analysed.ResultsCI decreased in both groups after the induction but less in the test group, almost reaching statistical significance (p=0,052). MAP also decreased more in the control group; however, not reaching statistical significance. HR decreased in both groups, significantly more in the test group (p=0,041). SVRI almost identically increased in both groups. SVI decreased in the control group, whereas it significantly increased after initial decrease in the test group (p=0,006). SVV slowly decreased under 10% in the test group and increased over 10% in the control group.ConclusionsOur results show that phenylephrine combined with crystalloid co-loading enables better circulatory stability than phenylephrine alone.Trial registrationThe study was registered on 15th of March 2017 at ISRCTN registry: http://www.isrctn.com/ISRCTN46293288 and was retrospectively registered.Clinical trial number is ISRCTN46293288.
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