Saghafinia Masoud, Jalali Alireza, Eskandari Mahnaz, Eskandari Nahid, Lak Marzieh
Department of Anaesthesiology, Faculty of Medical Science, Tehran, Iran.
Department of Anesthesiology, Baghyatollah Medical Sciences University, Tehran, Iran.
Adv Biomed Res. 2017 Sep 21;6:115. doi: 10.4103/abr.abr_151_16. eCollection 2017.
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.
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 1 and 5 min after birth was recorded.
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 ( > 0.05). Total dose of ephedrine and atropine were similar between groups ( > 0.05), respectively. There was no significant difference in Apgar score at the 1 and 5 min after birth between two groups. There were not any adverse effects of drugs in two groups.
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.
低血压是剖宫产脊髓麻醉后最常见的并发症之一。通常，通过预充液体，尤其是晶体液，来预防低血压。
在本随机临床试验研究中，120例美国麻醉医师协会分级为I级和II级的择期剖宫产产妇，分别接受15毫升生理盐水或7毫升/千克6%羟乙基淀粉（万汶）溶液。记录脊髓麻醉前以及麻醉后3、6、9、15和20分钟时的收缩压、舒张压、平均动脉压和心率、低血压发生率、不良反应、阿托品和麻黄碱的总剂量。此外，记录新生儿出生后1分钟和5分钟时的阿氏评分。
两组在脊髓麻醉刚结束时以及麻醉后3、6、15和20分钟等不同阶段的平均动脉压无显著差异（P>0.05）。两组麻黄碱和阿托品的总剂量分别相似（P>0.05）。两组出生后1分钟和5分钟时的阿氏评分无显著差异。两组均未出现药物不良反应。
本研究结果表明，在剖宫产脊髓麻醉期间，6%羟乙基淀粉预防低血压的效果与生理盐水相似。
