Abstract |
This study was designed to determine whether preoperative administration of 6% hetastarch decreases the incidence and severity of hypotension after spinal anesthesia for cesarean section. Forty nonlaboring ASA class I and II women having nonurgent cesarean sections were randomized to receive either 500 mL of 6% hetastarch plus 1 L lactated Ringer's solution (LR) (n = 20), or 2 L of LR (n = 20) prior to induction of spinal anesthesia. Hypotension occurred in 45% of patients who received hetastarch vs 85% of those who received only LR (P < 0.05), and minimum systolic blood pressure was lower in the LR group than in the hetastarch group (85 +/- 12 vs 93 +/- 12 mm Hg [mean +/- SD]; P < 0.05). In addition, the LR group had a higher maximum heart rate (115 +/- 17 vs 104 +/- 16 bpm), a shorter mean time to hypotension (7 +/- 4 vs 10 +/- 7 min), and required more 5-mg doses of ephedrine for treatment of hypotension (0 vs 2 [median]; P < 0.05) than the hetastarch group. Neonatal outcome, as determined by Apgar scores and cord blood gas analyses, was good and similar in both groups. We conclude that 6% hetastarch plus LR is more effective than LR alone and that its routine use before spinal anesthesia for cesarean section should be considered.
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Authors | E T Riley, S E Cohen, A J Rubenstein, B Flanagan |
Journal | Anesthesia and analgesia
(Anesth Analg)
Vol. 81
Issue 4
Pg. 838-42
(Oct 1995)
ISSN: 0003-2999 [Print] United States |
PMID | 7574020
(Publication Type: Clinical Trial, Comparative Study, Journal Article, Randomized Controlled Trial)
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Chemical References |
- Hydroxyethyl Starch Derivatives
- Isotonic Solutions
- Plasma Substitutes
- Ringer's Lactate
|
Topics |
- Anesthesia, Obstetrical
(adverse effects)
- Anesthesia, Spinal
(adverse effects)
- Apgar Score
- Birth Weight
- Cesarean Section
- Double-Blind Method
- Female
- Fetal Blood
(chemistry)
- Humans
- Hydroxyethyl Starch Derivatives
(administration & dosage)
- Hypotension
(etiology, prevention & control)
- Infant, Newborn
- Isotonic Solutions
(administration & dosage)
- Plasma Substitutes
(administration & dosage)
- Pregnancy
- Ringer's Lactate
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