Comparison of pentastarch and Hartmann's solution for volume preloading in spinal anaesthesia for elective caesarean section

We studied 160 patients undergoing elective Caesarean section under spinalanaesthesia who received a preloading volume of 15 ml kg-1 of 10%pentastarch in 0.9% saline, or Hartmann's solution, in a prospective,randomized, double-blind study. We compared the incidence of spinal-inducedhypotension in each group. Hypotension was defined as a decrease insystolic arterial pressure to less than 70% of baseline values or < or =90 mm Hg, whichever was the greater. The groups were comparable in physicalcharacteristics and there was no serious morbidity. Fetal outcome wassimilar in both groups. Significantly more patients in the Hartmann's group(n = 38, 47.5%) developed hypotension than in the pentastarch group (n =10, 12.5%) (P < 0.0001). Linear regression analysis showed that the onlysignificant variable was type of fluid used. Blood glucose concentrationswere not related to the presence of hypotension. We conclude that starchesmay be suitable for preloading in Caesarean section under spinalanaesthesia and provide an alternative to the aggressive use ofvasoconstrictors.