HYDROXYETHYLSTARCH COMPARED WITH MODIFIED GELATIN AS VOLUME PRELOAD BEFORE SPINAL-ANESTHESIA FOR CESAREAN-SECTION

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.