TY - JOUR
T1 - Phenylephrine infusion for spinal-induced hypotension in elective cesarean delivery
T2 - Does preload make a difference?
AU - Bottiger, Brandi A.
AU - Bezinover, Dmitri S.
AU - Mets, Berend
AU - Dalal, Priti G.
AU - Prozesky, Jansie
AU - Ural, Serdar
AU - Vaida, Sonia
N1 - Publisher Copyright:
©ournal of Anaesthesiology Clinical Pharmacology | Published by Wolters Kluwer - Medknow.
PY - 2016/7/1
Y1 - 2016/7/1
N2 - Background and Aims: Patients undergoing elective cesarean delivery (CD) have a high-risk of spinal-induced hypotension (SIH). We hypothesized that a colloid preload would further reduce SIH when compared with a crystalloid preload. Material and Methods: Eighty-two healthy parturients undergoing elective CD were included in the study. Patients were randomly assigned to two groups (41 patients in each group) to receive either Lactated Ringer's solution (1500 ml) or hydroxyethyl starch (6% in normal saline, 500 ml) 30 min prior to placement of spinal anesthesia. All patients were treated with a phenylephrine infusion (100 mcg/min), titrated during the study. Results: There was no statistical difference between groups with regards to the incidence of hypotension (10.8% in the colloid group vs. 27.0% in the crystalloid group, P = 0.12). There was also no difference between groups with respect to bradycardia, APGAR scores, and nausea and vomiting. Significantly less phenylephrine (1077.5 ± 514 mcg) was used in the colloid group than the crystalloid group (1477 ± 591 mcg, P = 0.003). Conclusion: The preload with 6% of hydroxyethyl starch before CD might be beneficial for the prevention of SIH.
AB - Background and Aims: Patients undergoing elective cesarean delivery (CD) have a high-risk of spinal-induced hypotension (SIH). We hypothesized that a colloid preload would further reduce SIH when compared with a crystalloid preload. Material and Methods: Eighty-two healthy parturients undergoing elective CD were included in the study. Patients were randomly assigned to two groups (41 patients in each group) to receive either Lactated Ringer's solution (1500 ml) or hydroxyethyl starch (6% in normal saline, 500 ml) 30 min prior to placement of spinal anesthesia. All patients were treated with a phenylephrine infusion (100 mcg/min), titrated during the study. Results: There was no statistical difference between groups with regards to the incidence of hypotension (10.8% in the colloid group vs. 27.0% in the crystalloid group, P = 0.12). There was also no difference between groups with respect to bradycardia, APGAR scores, and nausea and vomiting. Significantly less phenylephrine (1077.5 ± 514 mcg) was used in the colloid group than the crystalloid group (1477 ± 591 mcg, P = 0.003). Conclusion: The preload with 6% of hydroxyethyl starch before CD might be beneficial for the prevention of SIH.
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U2 - 10.4103/0970-9185.168159
DO - 10.4103/0970-9185.168159
M3 - Article
C2 - 27625478
AN - SCOPUS:84984672544
VL - 32
SP - 319
EP - 324
JO - Journal of Anaesthesiology Clinical Pharmacology
JF - Journal of Anaesthesiology Clinical Pharmacology
SN - 0970-9185
IS - 3
ER -