Preloading with HES 130/0.4 versus normal saline solution to prevent hypotension during spinal anaesthesia for elective caesarean section]

Objective. - To evaluate the efficacy of HES 130/0.4 preload compared to normal saline solution for prevention of hypotension during spinal anaesthesia for elective caesarean section. Study design. - Prospective, randomized. Patients and methods. - Sixty ASAI patients scheduled for elective caesarean section were randomized to receive either 1000 mL of normal saline solution preload (Group C) or 500 mL of HES 130/0.4 preload (Group V) within 15 minutes prior to spinal anaesthesia. Spinal anaesthesia techniques and ephedrine administration was standardized in both groups. The primary endpoint was the incidence of maternal hypotension before fetal extraction. Results. - The incidence of hypotension before fetal extraction was significantly lower in group V compared to group C (40% vs 66%, P = 0.03). Ephedrine consumption was significantly lower in group V (7.6 +/- 13 mg vs 16.4 +/- 15 mg). Lowest systolic blood pressure was significantly higher in group V (96 +/- 14 vs 85 +/- 14 mmHg, P=0.005). Incidence of adverse maternal effects and neonatal consequences were similar in both groups. Conclusion. - HES 130/0.4 preload reduced the incidence of hypotension, the duration of longest hypotension, and the need for ephedrine during spinal anaesthesia for elective caesarean section. However, the efficacy of HES 130/0.4 alone in prevention of maternal hypotension during spinal anaesthesia for caesarean section is still insufficient. (C) 2012 Societe francaise d'anesthesie et de reanimation (Sfar). Published by Elsevier Masson SAS. All rights reserved.