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Hydroxyethylstarch 10% is superior to Ringer's solution for preloading before spinal anesthesia for Cesarean section.
Can J Anaesth 2000; 47(7):616-21CJ

Abstract

PURPOSE

To compare the preloading effect of 500 ml hydroxyethylstarch (HES) 10% with 1 L Lactated Ringer's solution (LR).

METHODS

In 40 healthy women undergoing elective Cesarean section HES, 500 ml (n = 20), or LR, IL (n = 20), was administered during 10 min before spinal anesthesia. The incidence of hypotension, (systolic blood pressure < 80% of baseline and < 100 mm Hg), and the amount of ephedrine used to treat it were compared. Also, the incidence of nausea and/or vomiting were recorded. Neonatal outcome was assessed using Apgar scores and umbilical venous and arterial blood gases.

RESULTS

The incidence of hypotension was higher in the LR than in HES group (80% vs 40%). Mean minimum systolic blood pressure was lower in the LR than in the HES group (86.1 +/- 12.7 mm Hg vs 99.6 +/- 9.7 mm Hg P < 0.05). Systolic blood pressure < 90 mmHg occurred in two of 20 patients (10%) who received HES vs 11 of 20 patients (55%) who received LR (P < 0.05). More doses of ephedrine were required to treat hypotension in the LRthan in the HES group (35.3 +/- 18.4 mg vs 10.6 +/- 8.6 mg; P < 0.05). The incidence of nausea and/or vomiting was lower in the HES than in the crystalloid group. Neonatal outcome was good and similar in both groups.

CONCLUSION

Preloading patients undergoing elective Cesarean section with 500 ml HES 10%, decreases the incidence and severity of spinal-induced hypotension more than preloading with 1 L of LR solution.

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  • Publisher Full Text

    • Authors+Show Affiliations

    Siddik SM
    Department of Anesthesiology, American University of Beirut, Lebanon.
    Aouad MT
    No affiliation info available
    Kai GE
    No affiliation info available
    Sfeir MM
    No affiliation info available
    Baraka AS
    No affiliation info available

    MeSH

    AdultAnesthesia, ObstetricalAnesthesia, SpinalBlood SubstitutesCarbon DioxideCesarean SectionColloidsEphedrineFemaleFetal BloodHumansHydroxyethyl Starch DerivativesHypotensionInfant, NewbornIsotonic SolutionsOxygenPostoperative Nausea and VomitingPreanesthetic MedicationPregnancyRinger's LactateVasoconstrictor Agents

    Pub Type(s)

    Clinical Trial
    Comparative Study
    Journal Article
    Randomized Controlled Trial

    Language

    eng

    PubMed ID

    10930199

    Citation

    Siddik, S M., et al. "Hydroxyethylstarch 10% Is Superior to Ringer's Solution for Preloading Before Spinal Anesthesia for Cesarean Section." Canadian Journal of Anaesthesia = Journal Canadien D'anesthesie, vol. 47, no. 7, 2000, pp. 616-21.
    Siddik SM, Aouad MT, Kai GE, et al. Hydroxyethylstarch 10% is superior to Ringer's solution for preloading before spinal anesthesia for Cesarean section. Can J Anaesth. 2000;47(7):616-21.
    Siddik, S. M., Aouad, M. T., Kai, G. E., Sfeir, M. M., & Baraka, A. S. (2000). Hydroxyethylstarch 10% is superior to Ringer's solution for preloading before spinal anesthesia for Cesarean section. Canadian Journal of Anaesthesia = Journal Canadien D'anesthesie, 47(7), pp. 616-21.
    Siddik SM, et al. Hydroxyethylstarch 10% Is Superior to Ringer's Solution for Preloading Before Spinal Anesthesia for Cesarean Section. Can J Anaesth. 2000;47(7):616-21. PubMed PMID: 10930199.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Hydroxyethylstarch 10% is superior to Ringer's solution for preloading before spinal anesthesia for Cesarean section. AU - Siddik,S M, AU - Aouad,M T, AU - Kai,G E, AU - Sfeir,M M, AU - Baraka,A S, PY - 2000/8/10/pubmed PY - 2001/2/28/medline PY - 2000/8/10/entrez SP - 616 EP - 21 JF - Canadian journal of anaesthesia = Journal canadien d'anesthesie JO - Can J Anaesth VL - 47 IS - 7 N2 - PURPOSE: To compare the preloading effect of 500 ml hydroxyethylstarch (HES) 10% with 1 L Lactated Ringer's solution (LR). METHODS: In 40 healthy women undergoing elective Cesarean section HES, 500 ml (n = 20), or LR, IL (n = 20), was administered during 10 min before spinal anesthesia. The incidence of hypotension, (systolic blood pressure < 80% of baseline and < 100 mm Hg), and the amount of ephedrine used to treat it were compared. Also, the incidence of nausea and/or vomiting were recorded. Neonatal outcome was assessed using Apgar scores and umbilical venous and arterial blood gases. RESULTS: The incidence of hypotension was higher in the LR than in HES group (80% vs 40%). Mean minimum systolic blood pressure was lower in the LR than in the HES group (86.1 +/- 12.7 mm Hg vs 99.6 +/- 9.7 mm Hg P < 0.05). Systolic blood pressure < 90 mmHg occurred in two of 20 patients (10%) who received HES vs 11 of 20 patients (55%) who received LR (P < 0.05). More doses of ephedrine were required to treat hypotension in the LRthan in the HES group (35.3 +/- 18.4 mg vs 10.6 +/- 8.6 mg; P < 0.05). The incidence of nausea and/or vomiting was lower in the HES than in the crystalloid group. Neonatal outcome was good and similar in both groups. CONCLUSION: Preloading patients undergoing elective Cesarean section with 500 ml HES 10%, decreases the incidence and severity of spinal-induced hypotension more than preloading with 1 L of LR solution. SN - 0832-610X UR - https://www.unboundmedicine.com/medline/citation/10930199/Hydroxyethylstarch_10_is_superior_to_Ringer's_solution_for_preloading_before_spinal_anesthesia_for_Cesarean_section_ L2 - https://dx.doi.org/10.1007/BF03018992 DB - PRIME DP - Unbound Medicine ER -