title: [Preloading with HES 130/0.4 versus normal saline solution to prevent hypotension during spinal anaesthesia for elective caesarean section].
abstract: OBJECTIVE
  To evaluate the efficacy of HES 130/0.4 preload compared to normal saline solution for prevention of hypotension during spinal anaesthesia for elective caesarean section.
  
  
  METHODS
  Prospective, randomized.
  
  
  METHODS
  Sixty ASA I patients scheduled for elective caesarean section were randomized to receive either 1000 mL of normal saline solution preload (Group C) or 500 mL of HES 130/0.4 preload (Group V) within 15 minutes prior to spinal anaesthesia. Spinal anaesthesia techniques and ephedrine administration was standardized in both groups. The primary endpoint was the incidence of maternal hypotension before fetal extraction.
  
  
  RESULTS
  The incidence of hypotension before fetal extraction was significantly lower in group V compared to group C (40% vs 66%, P=0.03). Ephedrine consumption was significantly lower in group V (7.6 ± 13 mg vs 16.4 ± 15 mg). Lowest systolic blood pressure was significantly higher in group V (96 ± 14 vs 85 ± 14 mmHg, P=0.005). Incidence of adverse maternal effects and neonatal consequences were similar in both groups.
  
  
  CONCLUSIONS
  HES 130/0.4 preload reduced the incidence of hypotension, the duration of longest hypotension, and the need for ephedrine during spinal anaesthesia for elective caesarean section. However, the efficacy of HES 130/0.4 alone in prevention of maternal hypotension during spinal anaesthesia for caesarean section is still insufficient.
authors.affiliation: Service d'anesthésie-réanimation, centre de maternité et de néonatalogie de Tunis, faculté de médecine de Tunis, université de Tunis El Manar, rue Jabel Lakhdar, La Rabta, 1007 Tunis, Tunisie. mouradbouchnak@yahoo.fr
authors.forename: M
authors.initials: M
authors.lastname: Bouchnak
authors.forename: M
authors.initials: M
authors.lastname: Magouri
authors.forename: S
authors.initials: S
authors.lastname: Abassi
authors.forename: K
authors.initials: K
authors.lastname: Khemiri
authors.forename: F
authors.initials: F
authors.lastname: Tlili
authors.forename: H
authors.initials: H
authors.lastname: Troudi
authors.forename: H
authors.initials: H
authors.lastname: Trabelsi
authors.forename: H
authors.initials: H
authors.lastname: Jabri
authors.forename: A
authors.initials: A
authors.lastname: Ben Mabrouk
authors.forename: A
authors.initials: A
authors.lastname: Abid
authors.forename: H
authors.initials: H
authors.lastname: Maghrebi
mesh_terms: D000328:Adult; D000775:Anesthesia, Spinal; D001794:Blood Pressure / Q000502:physiology; D002585:Cesarean Section; D004809:Ephedrine; D005260:Female; D006801:Humans; D006895:Hydroxyethyl Starch Derivatives / Q000008:administration & dosage / Q000627:therapeutic use*; D007022:Hypotension / Q000517:prevention & control*; D007231:Infant, Newborn; D007431:Intraoperative Complications / Q000517:prevention & control*; D010952:Plasma Substitutes / Q000008:administration & dosage / Q000627:therapeutic use*; D011247:Pregnancy; D011446:Prospective Studies; D012965:Sodium Chloride / Q000008:administration & dosage / Q000627:therapeutic use*; D014662:Vasoconstrictor Agents
chemical_list: C485123:HES 130-0.4; D006895:Hydroxyethyl Starch Derivatives; D010952:Plasma Substitutes; D014662:Vasoconstrictor Agents; D012965:Sodium Chloride; D004809:Ephedrine