Préremplissage par HEA 130/0,4 versus sérum salé isotonique dans la prévention de l’hypotension au cours de la rachianesthésie pour césarienne programmée

Abstract

ObjectiveTo evaluate the efficacy of HES 130/0.4 preload compared to normal saline solution for prevention of hypotension during spinal anaesthesia for elective caesarean section. Study designProspective, randomized. Patients and methodsSixty ASA I patients scheduled for elective caesarean section were randomized to receive either 1000mL of normal saline solution preload (Group C) or 500mL of HES 130/0.4 preload (Group V) within 15minutes prior to spinal anaesthesia. Spinal anaesthesia techniques and ephedrine administration was standardized in both groups. The primary endpoint was the incidence of maternal hypotension before fetal extraction. ResultsThe incidence of hypotension before fetal extraction was significantly lower in group V compared to group C (40% vs 66%, P=0.03). Ephedrine consumption was significantly lower in group V (7.6±13mg vs 16.4±15mg). Lowest systolic blood pressure was significantly higher in group V (96±14 vs 85±14mmHg, P=0.005). Incidence of adverse maternal effects and neonatal consequences were similar in both groups. ConclusionHES 130/0.4 preload reduced the incidence of hypotension, the duration of longest hypotension, and the need for ephedrine during spinal anaesthesia for elective caesarean section. However, the efficacy of HES 130/0.4 alone in prevention of maternal hypotension during spinal anaesthesia for caesarean section is still insufficient.