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A study was conducted to assess the effect of Trendelenburg position (the position of the patient recumbent position with the head lower than feet), the solution infus HES (hydroxyethyl starch) or 6% solution infus RL rainfall changes in the heart after the anestesia Spinal lebihd ari patients aged 50 years.

In the study, 70 patients scheduled to undergo surgery under the extremity orthopedics anestesia Spinal and randomly divided into 3 groups.

In the Trendelenburg group, patients placed in Trendelenburg position immediately after Spinal block for 10 minutes. In the HES group patients get infus 500 mL 6% HES solution, and in the RL group, patients get a 1000 mL solution infus RL. Infus given during the second 20 minutes after Spinal block.

Rainfall measured in the heart of the ongoing since 15 minutes before until 30 minutes after the anestesia Spinal use one method cardiography and arterial blood pressure was measured with an automatic.

The results show that in the patients with the Trendelenburg position, the heart of rainfall does not change. In the HES group, rainfall means increased heart block after Spinal and still means to increase until the end of the measurement. In the RL group, the heart of increased rainfall means 10 and 20 minutes after Spinal block, but after infus distop, rainfall began to decrease heart.


Conclusion of the study is that a decrease in rainfall after the anestesia Spinal heart can be prevented by placing the patient in the Trendelenburg position, infus solution or 6% HES or RL, but RL solvent effect infus only temporary, while infus effect of 6% HES solution can survive beyond the time infus.



Previously, a study on 40 women with the operation sesar random and blind ganda given preload RL 1.5 L or 1 L HES 6% for 15 minutes in 30 minutes and then get Spinal block with bupivacaine hiperbarik also shows that the rainfall increased after heart preload with the second solution infus, but rainfall can be heart after Spinal anestesia only on groups that receive infus solution HES 6%.