Document Detail


Hydroxyethylstarch 10% is superior to Ringer's solution for preloading before spinal anesthesia for Cesarean section.
MedLine Citation:
PMID:  10930199     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
S M Siddik; M T Aouad; G E Kai; M M Sfeir; A S Baraka
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  Canadian journal of anaesthesia = Journal canadien d'anesthésie     Volume:  47     ISSN:  0832-610X     ISO Abbreviation:  Can J Anaesth     Publication Date:  2000 Jul 
Date Detail:
Created Date:  2000-11-08     Completed Date:  2000-11-15     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8701709     Medline TA:  Can J Anaesth     Country:  CANADA    
Other Details:
Languages:  eng     Pagination:  616-21     Citation Subset:  IM    
Affiliation:
Department of Anesthesiology, American University of Beirut, Lebanon.
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MeSH Terms
Descriptor/Qualifier:
Adult
Anesthesia, Obstetrical / adverse effects,  methods*
Anesthesia, Spinal / adverse effects,  methods*
Blood Substitutes / therapeutic use
Carbon Dioxide / blood
Cesarean Section / adverse effects,  methods*
Colloids / therapeutic use
Ephedrine / therapeutic use
Female
Fetal Blood / metabolism
Hetastarch / therapeutic use*
Humans
Hypotension / etiology,  prevention & control
Infant, Newborn
Isotonic Solutions / therapeutic use*
Oxygen / blood
Postoperative Nausea and Vomiting / etiology,  prevention & control
Preanesthetic Medication / methods
Pregnancy
Vasoconstrictor Agents / therapeutic use
Chemical
Reg. No./Substance:
0/Blood Substitutes; 0/Colloids; 0/Isotonic Solutions; 0/Vasoconstrictor Agents; 124-38-9/Carbon Dioxide; 299-42-3/Ephedrine; 7782-44-7/Oxygen; 8022-63-7/Ringer's lactate; 9005-27-0/Hetastarch
Comments/Corrections
Comment In:
Can J Anaesth. 2000 Jul;47(7):607-10   [PMID:  10930197 ]

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


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