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

ABSTRACT

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]. 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 IV 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]. 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. 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