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


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.


CONCLUSIONS
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.
Madi-Jebara
Samia
S
Department of Anesthesiology & Intensive Care, CHU Hôtel-Dieu de France Hospital, Beirut, Lebanon. smj20@hotmail.com
Ghosn
Anthony
A
Sleilaty
Ghassan
G
Richa
Freda
F
Cherfane
Amale
A
Haddad
Fadia
F
Yazigi
Alexandre
A
Antakly
Marie-Claire
MC
D018663:Adrenergic Agents / Q000008:administration & dosage / Q000627:therapeutic use; D000328:Adult; D000775:Anesthesia, Spinal; D002585:Cesarean Section; D003627:Data Interpretation, Statistical; D004809:Ephedrine / Q000008:administration & dosage / Q000627:therapeutic use; D005260:Female; D006801:Humans; D006895:Hydroxyethyl Starch Derivatives / Q000008:administration & dosage / Q000627:therapeutic use*; D007022:Hypotension / Q000188:drug therapy / Q000517:prevention & control*; D007231:Infant, Newborn; D007552:Isotonic Solutions / Q000008:administration & dosage / Q000627:therapeutic use*; D011247:Pregnancy; D011256:Pregnancy Outcome; D011446:Prospective Studies; D000077331:Ringer's Solution; D018709:Statistics, Nonparametric
D018663:Adrenergic Agents; C485123:HES 130-0.4; D006895:Hydroxyethyl Starch Derivatives; D007552:Isotonic Solutions; D000077331:Ringer's Solution; D004809:Ephedrine