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Prevention of Spinal Hypotension During Caesarean Section: Comparison of 6% Hydroxyethyl Starch and Ringer’s Lactate.
Abstract
Background: Volume preload with intravenous fluid is a method used in preventing spinal anaesthesia induced hypotension during caesarean section. We compared the efficacy of preloading with 1000ml Ringer’s Lactate (RL) solution versus 500ml 6% Hydroxyethyl starch (HES) in preventing hypotension in two groups of women undergoing elective caesarean section under spinal anaesthesia.
Patients and methods: With the approval of the Ethics Committee of our hospital 50 American Society of Anesthesiology
(ASA) physical status I and II women undergoing elective caesarean section under spinal anaesthesia were recruited for the study. The patients were either preloaded with 1000ml RL or with 500ml HES. After instituting spinal anaesthesia the patients’ blood pressure and heart rate were monitored. Hypotension was defined as systolic blood pressure (SBP) <80% of the baseline or absolute value of SBP < 100mmHg and was treated with rapid infusion of RL, then 5mg boluses of ephedrine.
Results: There were 25 women in each group and both groups had similar demographic characteristics. The incidence of hypotension was higher in the RL group (44% versus 32%) but was not statistically significant. The doses of ephedrine required and extra intravenous fluid received before delivery was similar in both groups. The incidence of nausea and/or vomiting was the same and neonatal outcome was also similar in the two groups.
Conclusion: The use of HES may be an alternative to RL where available. It is of particular advantage where a smaller volume of fluid is required for preload.
Key words: Spinal anaesthesia, caesarean section, hypotension
Patients and methods: With the approval of the Ethics Committee of our hospital 50 American Society of Anesthesiology
(ASA) physical status I and II women undergoing elective caesarean section under spinal anaesthesia were recruited for the study. The patients were either preloaded with 1000ml RL or with 500ml HES. After instituting spinal anaesthesia the patients’ blood pressure and heart rate were monitored. Hypotension was defined as systolic blood pressure (SBP) <80% of the baseline or absolute value of SBP < 100mmHg and was treated with rapid infusion of RL, then 5mg boluses of ephedrine.
Results: There were 25 women in each group and both groups had similar demographic characteristics. The incidence of hypotension was higher in the RL group (44% versus 32%) but was not statistically significant. The doses of ephedrine required and extra intravenous fluid received before delivery was similar in both groups. The incidence of nausea and/or vomiting was the same and neonatal outcome was also similar in the two groups.
Conclusion: The use of HES may be an alternative to RL where available. It is of particular advantage where a smaller volume of fluid is required for preload.
Key words: Spinal anaesthesia, caesarean section, hypotension
