The impact of colloid infusion prior to spinal anaesthesia for caesarean section on the condition of a newborn--a comparison of balanced and unbalanced hydroxyethyl starch 130/0.4.

BACKGROUND

Fluid therapy is the most commonly used treatment to prevent hypotension associated with spinal anaesthesia. The aim of this study was to test the hypothesis that a balanced solution of 6% hydroxyethyl starch will have a more beneficial impact on the condition of newborns at birth than an unbalanced 6% solution of HES.

METHODS

The study participants included 51 healthy parturients undergoing elective caesarean section with spinal anaesthesia. Patients received a transfusion of 500 mL of unbalanced 6% HES (Voluven) or balanced 6% HES (Tetraspan) prior to anaesthesia. The condition of the newborn was assessed using the Apgar score, and the acid-base balances of venous and arterial umbilical cord blood were also measured.

RESULTS

The incidence of hypotension after spinal anaesthesia was 80% in Group A and 76.9% in Group B (P = 1.0). There were no differences between the two groups in the total doses of ephedrine and no differences between treatment groups in Apgar scores. Also, no differences in acid-base balance parameters (pH, H(+), pCO(2), pO(2), HCO(3)(-), BE) were found.

CONCLUSION

A balanced 6% solution of hydroxyethyl starch (HES 130/0.42) did not significantly influence the condition of the newborns at birth or the acid-base and electrolyte concentration of newborns compared to an unbalanced solution of 6% hydroxyethyl starch (HES 130/0.4).