Document Detail


Colloid vs. crystalloid preloading to prevent maternal hypotension during spinal anesthesia for elective cesarean section.
MedLine Citation:
PMID:  16095463     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Hypotension associated with spinal anesthesia for cesarean section is still a clinical problem. Colloid solutions seem preferable to crystalloid solutions for preloading. In most studies the overall rate of hypotension is reported. Few studies have, however, investigated the maternal and neonatal consequences of different levels of maternal hypotension. METHODS: In this randomized, double-blinded study 110 patients presenting for elective cesarean section received either 1000 ml acetated Ringer's solution or 1000 ml 3% dextran 60 solution immediately before spinal anesthesia. The effect on overall hypotension, clinically significant hypotension (hypotension associated with maternal discomfort defined as nausea, retching/vomiting, dizziness or chest symptoms) and severe hypotension (systolic arterial pressure <80 mmHg) was studied. RESULTS: Dextran reduced the incidence of overall hypotension from 85 to 66% (P=0.03), reduced the incidence of clinically significant hypotension from 60 to 30% (P=0.002) and reduced the incidence of severe hypotension from 23 to 3.6% (P=0.004) compared to Ringer's solution. There were neither differences in neonatal outcome between treatment groups nor between neonates grouped after severity of maternal hypotension. CONCLUSION: Clinically significant hypotension seems to be a more suitable outcome variable than overall hypotension. The protective effect of the colloid solution increased with increased severity of hypotension.
Authors:
G Dahlgren; F Granath; K Pregner; P G Rösblad; H Wessel; L Irestedt
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  Acta anaesthesiologica Scandinavica     Volume:  49     ISSN:  0001-5172     ISO Abbreviation:  Acta Anaesthesiol Scand     Publication Date:  2005 Sep 
Date Detail:
Created Date:  2005-08-12     Completed Date:  2005-11-08     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0370270     Medline TA:  Acta Anaesthesiol Scand     Country:  Denmark    
Other Details:
Languages:  eng     Pagination:  1200-6     Citation Subset:  IM    
Affiliation:
Department of Anesthesia and Intensive Care, Karolinska University Hospital, Stockholm, Sweden. gunnar.dahlgren@kirurgi.ki.se
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MeSH Terms
Descriptor/Qualifier:
Adult
Anesthesia, Obstetrical / adverse effects*
Anesthesia, Spinal / adverse effects*
Apgar Score
Carbon Dioxide / blood
Central Nervous System Stimulants / therapeutic use
Cesarean Section / adverse effects,  methods*
Colloids / therapeutic use
Dextrans / therapeutic use*
Double-Blind Method
Ephedrine / therapeutic use
Female
Humans
Hydrogen-Ion Concentration / drug effects
Hypotension / etiology,  prevention & control*
Infant, Newborn
Isotonic Solutions / therapeutic use
Plasma Substitutes / therapeutic use*
Preoperative Care / methods*
Reference Values
Surgical Procedures, Elective / methods
Umbilical Arteries / drug effects
Chemical
Reg. No./Substance:
0/Central Nervous System Stimulants; 0/Colloids; 0/Isotonic Solutions; 0/Plasma Substitutes; 0/crystalloid solutions; 124-38-9/Carbon Dioxide; 299-42-3/Ephedrine; 8026-10-6/Ringer's solution; 9004-54-0/Dextrans

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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