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Prevention of hypotension after spinal anesthesia for cesarean section: 6% hydroxyethyl starch 130/0.4 (Voluven) versus lactated Ringer's solution.

AbstractGOALS:
The aim of this study is to compare the efficacy of HES 130/0.4, a new hydroxyethyl starch, to lactated Ringer's solution (LR) in the prevention of hypotension after spinal anesthesia for cesarean section (CS).
MATERIAL AND METHODS:
One hundred and twenty nonlaboring ASA I and II women having non urgent CS were enrolled in this prospective and randomized study. Subjects were randomly assigned to receive prior to anesthesia either 1 liter of LR (Gr I: n = 59) or 500 ml of HES 130/0.4 (Gr II : n = 61). Blood pressure was measured until discharge from the post anesthesia care unit. Hypotension was treated with i.v. boluses of 3 mg of ephedrine. The nausea scale was recorded. Arterial and venous umbilical blood gazes were obtained. Data were compared using Mann-Whitney U-test and Student's t-test (p < 0.05 was significant).
RESULTS:
Thirty-nine patients in Gr II while 48 pts in Gr I experienced hypotension (p = .033). The total dose of ephedrine was statistically smaller in Gr II compared with Gr I (p = .001). Nausea after induction of spinal anesthesia occurred with similar frequency in both groups. Neonatal outcome was excellent and similar in both groups.
CONCLUSION:
HES 130/0.4 is more effective than LR to prevent hypotension following spinal anesthesia for CS; its routine use in this purpose should be considered.
AuthorsSamia Madi-Jebara, Anthony Ghosn, Ghassan Sleilaty, Freda Richa, Amale Cherfane, Fadia Haddad, Alexandre Yazigi, Marie-Claire Antakly
JournalLe Journal medical libanais. The Lebanese medical journal (J Med Liban) 2008 Oct-Dec Vol. 56 Issue 4 Pg. 203-7 ISSN: 0023-9852 [Print] Lebanon
PMID19115593 (Publication Type: Comparative Study, Journal Article, Randomized Controlled Trial)
Chemical References
  • Adrenergic Agents
  • HES 130-0.4
  • Hydroxyethyl Starch Derivatives
  • Isotonic Solutions
  • Ringer's Solution
  • Ephedrine
Topics
  • Adrenergic Agents (administration & dosage, therapeutic use)
  • Adult
  • Anesthesia, Spinal
  • Cesarean Section
  • Data Interpretation, Statistical
  • Ephedrine (administration & dosage, therapeutic use)
  • Female
  • Humans
  • Hydroxyethyl Starch Derivatives (administration & dosage, therapeutic use)
  • Hypotension (drug therapy, prevention & control)
  • Infant, Newborn
  • Isotonic Solutions (administration & dosage, therapeutic use)
  • Pregnancy
  • Pregnancy Outcome
  • Prospective Studies
  • Ringer's Solution
  • Statistics, Nonparametric

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