Prévention de l’hypotension induite par la rachianesthésie au cours de la césarienne programmée : coremplissage par HEA 130/0,4 vs sérum salé isotonique

Abstract

Objective

The aim of this study was to compare the efficacy of HES 130/0.4 coloading compared to normal saline solution for prevention of hypotension during spinal anesthesia for elective caesarean section.

Study design

Prospective, randomized.

Patients and methods

One hundred and twenty ASA I and II patients scheduled for elective caesarean section were recruited. Patients were randomized to receive either 500 mL of HES 130/0.4 (Voluven^®) coloading (Group V) or 500 mL of normal saline solution coloading (Group C). Spinal anesthesia technique and ephedrine administration were standardized in both groups. The primary endpoint was the incidence of maternal hypotension during spinal anesthesia for elective caesarean section.

Results

Hypotension occurred in 43 patients in group C and 24 patients in group V (p = 0.001). Ephedrine consumption was significantly lower in group V (P = 0.005). Nausea, vomiting and headache incidence was higher in group C (p = 0.006). Apgar scores and umbilical blood gazes were comparable between groups.

Conclusion

HES 130/0.4 coload was more effective than normal saline solution to prevent hypotension following spinal anesthesia for elective cesarean section. HES 130/0.4 coload reduced the incidence, the duration of longest hypotension, the need for ephedrine and the adverse maternal effects.