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. 2014 Oct;8(4):456-62.
doi: 10.4103/1658-354X.140817.

Prevention of altered hemodynamics after spinal anesthesia: A comparison of volume preloading with tetrastarch, succinylated gelatin and ringer lactate solution for the patients undergoing lower segment caesarean section

Tapobrata Mitra  1 , Anjan Das  2 , Saikat Majumdar  3 , Tapas Bhattacharyya  2 , Rahul Deb Mandal  4 , Bimal Kumar Hajra  3
Affiliations

Prevention of altered hemodynamics after spinal anesthesia: A comparison of volume preloading with tetrastarch, succinylated gelatin and ringer lactate solution for the patients undergoing lower segment caesarean section

Tapobrata Mitra et al. Saudi J Anaesth. 2014 Oct.

Retraction in

  • Retraction.
    [No authors listed] [No authors listed] Saudi J Anaesth. 2020 Jul-Sep;14(3):422. doi: 10.4103/1658-354X.285417. Saudi J Anaesth. 2020. PMID: 32934651 Free PMC article.

Abstract

Background: Spinal anesthesia has replaced general anesthesia in obstetric practice. Hemodynamic instability is a common, but preventable complication of spinal anesthesia. Preloading the circulation with intravenous fluids is considered a safe and effective method of preventing hypotension following spinal anesthesia. We had conducted a study to compare the hemodynamic stability after volume preloading with either Ringer's lactate (RL) or tetrastarch hydroxyethyl starch (HES) or succinylated gelatin (SG) in the patients undergoing cesarean section under spinal anesthesia.

Materials and methods: It was a prospective, double-blinded and randomized controlled study. Ninety six ASA-I healthy, nonlaboring parturients were randomly divided in 3 groups HES, SG, RL (n = 32 each) and received 10 ml/kg HES 130/0.4; 10 ml/kg SG (4% modified fluid gelatin) and 20 ml/kg RL respectively prior to SA scheduled for cesarean section. Heart rate, blood pressure (BP), oxygen saturation was measured.

Results: The fall in systolic blood pressure (SBP) (<100 mm Hg) noted among 5 (15.63%), 12 (37.5%) and 14 (43.75%) parturients in groups HES, SG, RL respectively. Vasopressor (phenylephrine) was used to treat hypotension when SBP <90 mm Hg. Both the results and APGAR scores were comparable in all the groups. Lower preloading volume and less intra-operative vasopressor requirement was noted in HES group for maintaining BP though it has no clinical significance.

Conclusion: RL which is cheap, physiological and widely available crystalloid can preload effectively and maintain hemodynamic stability well in cesarean section and any remnant hypotension can easily be manageable with vasopressor.

Keywords: Caesarean section; Ringer lactate; hydroxyethyl starch; spinal anesthesia; succinylated gelatin.

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Conflict of interest statement

Conflict of Interest: None declared.

Figures

Figure 1
Figure 1
Mean heart rate among hydroxyethyl starch, succinylated gelatin and Ringer's lactate group
Figure 2
Figure 2
Mean arterial pressure among hydroxyethyl starch, succinylated gelatin and Ringer's lactate group
Figure 3
Figure 3
Mean systolic pressure among hydroxyethyl starch, succinylated gelatin and Ringer's lactate group
See this image and copyright information in PMC

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