The Effects of 10 % Pentastarch Preloading for Cesarean Section Under Epidural Anesthesia / 대한마취과학회지

ABSTRACT

Epidural anesthesia is the most commonly used anesthesia for cesarean section. But preg- nant women under epidural anesthesia for cesarean section are particularly prone to arterial hypotension following sympathetic blockade. Its prevention is the most important thing to obstetric anesthetists. Forty women at term were randomly allocated to receive either 1,500ml of crystalloid (Hartmann's solution) or 500ml of colloid solution (10% pentastarch) in order to preload the circulation prior to elective cesarean section under epidural anesthesia. And to investigate the adverse effect of pentastarch on coagulation, other forty mothers undergoing cesarean section under general anesthesia were examined with computerized thrombelastograph coagulation analyzer(TEG) before and after 1,500ml of Hartmanns solution or 500ml of 10% pentastarch preloading (each group n=20). There were no differences in the incidence of hypotension, degree of hemodilution, umbilical cord blood gas tension and TEG findings between the two groups. But the serial change of the central venous pressure of the Hartmann group from fluid preloading to anesthesia and operation was significantly different from that of pentastarch group (p<0.05). The TEG findings before fluid preloading presented the hypercoagulable stste of the pregnant women at term, and no adverse effect of pentastarch on coagulation except hemodilution. It was concluded that 10% pentastarch was a good choice as a circulatory preloading agent for cesarean section under epidural anesthesia.