Hydroxyethylstarch 10% is superior to Ringer's solution for preloading before spinal anesthesia for Cesarean section

Purpose: To compare the preloading effect of 500 ml hydroxyethylstarch (HES ) 10% with IL Lactated Ringer's solution (LR). Methods: In 40 healthy women undergoing elective Cesarean section HES, 500 ml (n = 20), or LR, IL (n = 20), was administered during 10 min before spin al anesthesia. The incidence of hypotension, (systolic blood pressure < 80% of baseline and < 100 mm Hg), and the amount of ephedrine used to treat it were compared. Also, the incidence of nausea and/or vomiting were recorded . Neonatal outcome was assessed using Apgar scores and umbilical venous and arterial blood gases. Results: The incidence of hypotension was higher in the LR than in HES grou p (80% vs 40%), Mean minimum systolic blood pressure was lower in the LR th an in the HES group (86.1 +/- 12.7 mm Hg vs 99.6 +/- 9.7 mm Hg P < 0.05). S ystolic blood pressure < 90 mmHg occurred in two of 20 patients (10%) who r eceived HES vs 11 of 20 patients (55%) who received LR (P < 0.05). More dos es of ephedrine were required to treat hypotension in the LR than in the HE S group (35.3 +/- 18.4 mg vs 10.6 +/- 8.6 mg; P < 0.05), The incidence of n ausea and/or vomiting was lower in the HES than in the crystalloid group. N eonatal outcome was good and similar in both groups. Conclusion: Preloading patients undergoing elective Cesarean section with 5 00 mi HES 10%, decreases the incidence and severity of spinal-induced hypot ension more than preloading with IL of LR solution.