Comparison of Hydroxyethyl Starch 6% and Crystalloids for Preloading in Elective Caesarean Section Under Spinal Anesthesia

Alimian, Mahzad; Mohseni, Masood; Salehi, Reza; Faiz, Seyed Hamid Reza; Majedi, Mohammad Azad

doi:10.5455/medarh.2014.68.279-281

Cited by 20 publications

(14 citation statements)

References 23 publications

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“…Mean percentage of HR changes showed a significant difference between the intervention groups; the rate of changes was more in the crystalloid group than the colloid group. These findings were not consistent with those of Alimian et al, in which HR changes showed no significant difference between the two groups ( 17 ). Average injected ephedrine was significantly lower in the colloid solution group than the other group and this was not consistent with the results of Unlugenc et al, in which injected ephedrine showed no significant difference between the two intervention groups ( 18 ).…”

Section: Discussioncontrasting

confidence: 97%

“…After estimating average Apgar at minutes one and five and according to the results, no significant difference was reported and it was consistent with the findings of Alimian et al, where the Apgar scores showed no significant difference between the two groups. The amounts of the total infused solution after spinal anesthesia were significantly different between the two intervention groups, where the colloid solution showed lower amount ( 17 ). This finding was not consistent with that of the study conducted by Unlugenc et al, where the average solution injected after spinal anesthesia did not show significant difference between the two groups ( 18 ).…”

Section: Discussionmentioning

confidence: 96%

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The Effects of Pre-Spinal Anesthesia Administration of Crystalloid and Colloid Solutions on Hypotension in Elective Cesarean Section

et al. 2018

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BackgroundSpinal anesthesia is an appropriate alternative for general anesthesia in many operations, particularly in cesarean section. However, the induced hypotension is the main drawback of this method. Therefore, the current study aimed at comparing the effects of crystalloid and colloid solutions used as the preload on the post-spinal hypotension and its complications in females who are candidate for elective cesarean section.MethodsThe current randomized, controlled, double-blind study was conducted on the female candidate of elective cesarean section (n = 96; age range: 20 to 40 years). The patients were in their 37 to 42 weeks of gestational age during the experiments. The systolic blood pressure (SBP), diastolic blood pressure (DBP), heart rate (HR) variation, amount of injected ephedrine during surgery, Apgar score at birth, total solution infused after spinal anesthesia, urine output, nausea, and vomiting were comparatively assessed between the two groups.ResultsThe percentages of reduction in SBP and DBP variables in the crystalloid solution were higher than those of the colloid group and the differences were statistically significant (P = 0.042 and P = 0.008, respectively). Average percentage of HR changes was more significant in the crystalloid than the colloid group (P = 0.032). In contrary, administration of the two types of solutions did not result in significant differences in the Apgar scores. The prevalence of nausea and vomiting in the colloid group subjects was lower than those of the crystalloid solution group; however, the differences were not significant.ConclusionsThe current study findings recommend colloid solution to prevent hemodynamic instability after spinal anesthesia. However, the costs and availability of the solution and recommendation of anesthesiologist should be considered. Conduction of further clinical trials with larger sample sizes is recommended.

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Section: Discussioncontrasting

confidence: 97%

Section: Discussionmentioning

confidence: 96%

The Effects of Pre-Spinal Anesthesia Administration of Crystalloid and Colloid Solutions on Hypotension in Elective Cesarean Section

et al. 2018

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“…We included 109 out of 1021 retrieved trials, which included 8561 women (Fig. and see also Supporting Information, Table S1) . Twelve interventions (eleven active treatments and one inactive control) to prevent intra‐operative hypotension were studied, with 30 direct comparisons (see also Supporting Information, Table S2).…”

Section: Resultsmentioning

confidence: 99%

Prevention of hypotension after spinal anaesthesia for caesarean section: a systematic review and network meta‐analysis of randomised controlled trials

et al. 2019

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Summary Spinal anaesthesia for caesarean section commonly causes maternal hypotension. This systematic review and network meta‐analysis compared methods to prevent hypotension in women receiving spinal anaesthesia for caesarean section. We selected randomised controlled trials that compared an intervention to prevent hypotension with another intervention or inactive control by searching MEDLINE and Embase, Web of Science to December 2018. There was no language restriction. Two reviewers extracted data on trial characteristics, methods and outcomes. We assessed risk of bias for individual trials (Cochrane tool) and quality of evidence (GRADE checklist). We assessed 109 trials (8561 women) and 12 different methods that resulted in 30 direct comparisons. Methods ranked by OR (95%CI) from most effective to least effective were: metaraminol 0.11 (0.04–0.26); norepinephrine 0.13 (0.06–0.28); phenylephrine 0.18 (0.11–0.29); leg compression 0.25 (0.14–0.43); ephedrine 0.28 (0.18–0.43); colloid given before induction of anaesthesia 0.38 (0.24–0.61); angiotensin 2, 0.12 (0.02–0.75); colloid given after induction of anaesthesia 0.52 (0.30–0.90); mephentermine 0.09 (0.01–1.30); crystalloid given after induction of anaesthesia 0.78 (0.46–1.31); and crystalloid given before induction of anaesthesia 1.16 (0.76–1.79). Phenylephrine caused maternal bradycardia compared with control, OR (95%CI) 0.23 (0.07–0.79). Ephedrine lowered umbilical artery pH more than phenylephrine, standardised mean difference (95%CI) 0.78 (0.47–1.49). We conclude that vasopressors should be given to healthy women to prevent hypotension during caesarean section with spinal anaesthesia.

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“…In all newborn babies (except 8 babies in the control group and 10 babies in case group) at least had Apgar score[ 9 ] at 1 st min and Apgar score[ 10 ] at 5 th min which there was not significant difference in two groups ( P > 0.05). Babies who have lower Apgar score had not an Apgar score of <8 at 5 th min in two groups ( P > 0.05).…”

Section: Resultsmentioning

confidence: 92%

“…reported the prevalence of hypotension after spinal anesthesia in parturients is between 80% and 90%. [ 5 9 10 11 ] Dahlgren et al . by applying 1000 cc liquid 3% dextran immediately before spinal anesthesia for elective cesarean section compared to Ringer's lactate reported that the overall incidence of hypotension reduces from 85% to 66%, incidence of clear clinical hypotension reduces from 60% to 30% and Severe hypotension reduces from 23% to 3.6%.…”

Section: Discussionmentioning

confidence: 99%

The Effects of Hydroxyethyl Starch 6% and Crystalloid on Volume Preloading Changes following Spinal Anesthesia

Saghafinia¹,

Jalali²,

Eskandari³

et al. 2017

Adv Biomed Res

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Background:Hypotension is one of the most common complications after spinal anesthesia for cesarean delivery. Normally, preloading with fluids, especially crystalloids, is used to prevention of hypotension.Methods:In the present randomized clinical trial study, 120 parturients presenting for elective cesarean section with the American Society of Anesthesiologists Class I and II received either 15 cc normal saline or 7 cc/kg hydroxyethyl starch 6% (Voluven) fluid. Information regarding to systolic, diastolic, mean arterial pressure, and heart rate, incidence of hypotension, adverse effects, the total dose of atropine, and ephedrine were recorded in before and 3, 6, 9, 15, and 20 min after spinal anesthesia. Furthermore, Apgar score of newborn at the 1st and 5th min after birth was recorded.Results:There was no significant difference in mean arterial pressure at different stages such as: Exactly after spinal and 3, 6, 15, and 20 min after spinal anesthesia between two groups (P > 0.05). Total dose of ephedrine and atropine were similar between groups (P > 0.05), respectively. There was no significant difference in Apgar score at the 1st and 5th min after birth between two groups. There were not any adverse effects of drugs in two groups.Conclusions:The results of this study show that hydroxyethyl starch 6% compared to normal saline are similar to prevent hypotension during spinal anesthesia for cesarean delivery.

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Comparison of Hydroxyethyl Starch 6% and Crystalloids for Preloading in Elective Caesarean Section Under Spinal Anesthesia

Cited by 20 publications

References 23 publications

The Effects of Pre-Spinal Anesthesia Administration of Crystalloid and Colloid Solutions on Hypotension in Elective Cesarean Section

The Effects of Pre-Spinal Anesthesia Administration of Crystalloid and Colloid Solutions on Hypotension in Elective Cesarean Section

Prevention of hypotension after spinal anaesthesia for caesarean section: a systematic review and network meta‐analysis of randomised controlled trials

The Effects of Hydroxyethyl Starch 6% and Crystalloid on Volume Preloading Changes following Spinal Anesthesia

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