Mp. Vercauteren et al., HYDROXYETHYLSTARCH COMPARED WITH MODIFIED GELATIN AS VOLUME PRELOAD BEFORE SPINAL-ANESTHESIA FOR CESAREAN-SECTION, British Journal of Anaesthesia, 76(5), 1996, pp. 731-733
We studied 90 patients undergoing elective Caesarean section under spi
nal anaesthesia who received lactated Ringer's solution 1000 ml with u
p to 1000 ml of modified gelatin, lactated Ringer's solution 1000 ml w
ith 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 o
f the colloid were infused. The incidence of hypotension, number of pa
tients requiring a vasopressor and doses of ephedrine required to rest
ore arterial pressure were significantly lower in favour of those rece
iving the crystalloid-hydroxyethylstarch combination. In both groups r
eceiving the 2000 ml preload, packed cell volume (PCV) values decrease
d by more than 20%, which may be of concern in patients already presen
ting with mild anaemia. In patients who received the colloid without t
he crystalloid, PCV values decreased by 14% but the risk of severe hyp
otension was comparable with the crystalloid-gelatin combination.