1Associate Professor, Dept. of Anaesthesiology, Saveetha Medical College, Chennai
2Assistant Professor, Sri Muthukumaran Medical College & Research Institute, Chennai
3Senior Resident, Dept. of Anaesthesiology, K.A.P.V. Govt. Medical College, Tiruchirappalli
4Assistant Professor, Dept. of Obstetrics and Gynaecology, Saveetha Medical College, Chennai
Hypotension after spinal anaesthesia is preventable by adequate pre-loading with colloids or crystalloids. Women posted for emergency caesarean section are more vulnerable for hypotension as they are not preloaded adequately due to time constraints. The idea of the study is to maintain haemodynamics by administering preload solution without any delay. Here 6% Hydoxyethyl starch (HES) is compared with Ringer lactate (RL) as a preloading solution.
50 pregnant women posted for emergency caesarean section were randomly allocated into 2 groups – Group H of 25 women received 500 ml of 6% HES and Group R of 25 women received 500 ml of RL intravenously as preload prior to spinal anaesthesia. The requirement of ephedrine to counter hypotension and the changes in the haemodynamic parameters were noted. Statistical analysis was done using Student's ‘t’ test, Fisher's test and Chi square test, and p <0.05 was considered statistically significant.
The requirement of ephedrine was less in 6% HES group (p <0.001). The haemodynamical parameters were more stable in 6% HES group where there was minimal fall in blood pressure (p < 0.001) and minimal rise in heart rate (p <0.01) compared to RL group.
The administration of 6% HES as a preloading solution before spinal anaesthesia in pregnant women undergoing Emergency Caesarean section is superior to Ringer lactate as it causes less incidence of hypotension and requires less ephedrine and intra-operative intravenous fluids.
6% Hydroxyethyl starch, Hypotension, Pre-loading, Spinal anaesthesia, Emergency caesarean section
