A randomised trial comparing 5 mL/kg and 10 mL/kg of pentastarch as a volume preload before spinal anaesthesia for elective caesarean section.
BACKGROUND
Colloid solutions are more effective at preventing hypotension than crystalloids when used as a volume preload before caesarean delivery under spinal anaesthesia. The ideal volume to infuse has not been established.


METHODS
In a randomised double-blind trial 70 women presenting for elective caesarean section received either 5 mL/kg of pentastarch (group A) or 10 mL/kg of pentastarch (group B) as a volume preload before spinal anaesthesia. Hypotension was defined as a systolic pressure below 90 mmHg or a decrease of 30% from a baseline value. Treatment was with 6-mg increments of ephedrine until resolution.


RESULTS
In group B, 7/35 patients (20%) developed hypotension, significantly fewer than the 15/35 (42.8%) in group A (P<0.05). The patients in group B also required less ephedrine (total in group, 114 mg) than those in group A (total in group, 198 mg)


CONCLUSIONS
Pentastarch, 10 mL/kg is more effective than 5 mL/kg at preventing hypotension following spinal anaesthesia for caesarean delivery.
Davies
P
P
Northampton General Hospital, Northampton, UK. Polly.Davies@ngh.nhs.uk
French
G W G
GW
D000328:Adult; D000775:Anesthesia, Spinal; D002585:Cesarean Section; D004311:Double-Blind Method; D017558:Elective Surgical Procedures; D005260:Female; D006801:Humans; D006895:Hydroxyethyl Starch Derivatives / Q000008:administration & dosage*; D007022:Hypotension / Q000517:prevention & control*; D010952:Plasma Substitutes / Q000008:administration & dosage*; D011247:Pregnancy
D006895:Hydroxyethyl Starch Derivatives; D010952:Plasma Substitutes