Marciniak Andrzej, Wujtewicz Maria, Owczuk Radosław
Department of Anaesthesiology and Intensive Therapy, Medical University of Gdansk, Poland.
Anaesthesiol Intensive Ther. 2013 Jan-Mar;45(1):14-9. doi: 10.5603/AIT.2013.0003.
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.
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.
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.
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).
液体疗法是预防与脊髓麻醉相关的低血压最常用的治疗方法。本研究的目的是检验以下假设：与不平衡的6%羟乙基淀粉溶液相比，平衡的6%羟乙基淀粉溶液对新生儿出生时的状况有更有益的影响。
研究参与者包括51例接受择期剖宫产脊髓麻醉的健康产妇。患者在麻醉前输注500 mL不平衡的6%羟乙基淀粉（万汶）或平衡的6%羟乙基淀粉（贺斯）。使用阿氏评分评估新生儿的状况，并测量脐静脉血和动脉血的酸碱平衡。
A组脊髓麻醉后低血压的发生率为80%，B组为76.9%（P = 1.0）。两组间麻黄碱的总剂量无差异，治疗组间阿氏评分也无差异。此外，酸碱平衡参数（pH、H⁺、pCO₂、pO₂、HCO₃⁻、BE）也没有差异。
与不平衡的6%羟乙基淀粉溶液（HES 130/0.4）相比，平衡的6%羟乙基淀粉溶液（HES 130/0.42）对新生儿出生时的状况或新生儿的酸碱及电解质浓度没有显著影响。
