Hydroxyethylstarch compared with modified gelatin as volume preload before spinal anaesthesia for Caesarean section |
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Authors: | Vercauteren M P; Hoffmann V; Coppejans H C; Van Steenberge A L; Adriaensen H A |
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Institution: | Department of Anaesthesiology, University Hospital Antwerp, Wilrijkstraat 10, B-2650 Edegem, Belgium |
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Abstract: | We studied 90 patients undergoing elective Caesarean section under spinal
anaesthesia who received lactated Ringer's solution 1000 ml with up to 1000
ml of modified gelatin, lactated Ringer's solution 1000 ml with up to 1000
ml of 6% hydroxyethylstarch or only up to 1000 ml of 6% hydroxyethylstarch.
Lumbar puncture was performed as soon as 500 ml of the colloid were
infused. The incidence of hypotension, number of patients requiring a
vasopressor and doses of ephedrine required to restore arterial pressure
were significantly lower in favour of those receiving the
crystalloid-hydroxyethylstarch combination. In both groups receiving the
2000 ml preload, packed cell volume (PCV) values decreased by more than
20%, which may be of concern in patients already presenting with mild
anaemia. In patients who received the colloid without the crystalloid, PCV
values decreased by 14% but the risk of severe hypotension was comparable
with the crystalloid-gelatin combination.
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