• J Med Liban · Oct 2008

    Randomized Controlled Trial Comparative Study

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

    • Samia Madi-Jebara, Anthony Ghosn, Ghassan Sleilaty, Freda Richa, Amale Cherfane, Fadia Haddad, Alexandre Yazigi, and Marie-Claire Antakly.
    • Department of Anesthesiology & Intensive Care, CHU Hôtel-Dieu de France Hospital, Beirut, Lebanon. smj20@hotmail.com
    • J Med Liban. 2008 Oct 1;56(4):203-7.

    GoalsThe 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).Material And MethodsOne 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).ResultsThirty-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.ConclusionHES 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.

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