Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2018 Aug 8;8(4):e69446.
doi: 10.5812/aapm.69446. eCollection 2018 Aug.

The Effects of Pre-Spinal Anesthesia Administration of Crystalloid and Colloid Solutions on Hypotension in Elective Cesarean Section

Mohammad Reza Gousheh  1 , Reza Akhondzade  1 , Hamid Asl Aghahoseini  1 , Alireza Olapour  1 , Mahbobe Rashidi  1
Affiliations

The Effects of Pre-Spinal Anesthesia Administration of Crystalloid and Colloid Solutions on Hypotension in Elective Cesarean Section

Mohammad Reza Gousheh et al. Anesth Pain Med. .

Abstract

Background: Spinal anesthesia is an appropriate alternative for general anesthesia in many operations, particularly in cesarean section. However, the induced hypotension is the main drawback of this method. Therefore, the current study aimed at comparing the effects of crystalloid and colloid solutions used as the preload on the post-spinal hypotension and its complications in females who are candidate for elective cesarean section.

Methods: The current randomized, controlled, double-blind study was conducted on the female candidate of elective cesarean section (n = 96; age range: 20 to 40 years). The patients were in their 37 to 42 weeks of gestational age during the experiments. The systolic blood pressure (SBP), diastolic blood pressure (DBP), heart rate (HR) variation, amount of injected ephedrine during surgery, Apgar score at birth, total solution infused after spinal anesthesia, urine output, nausea, and vomiting were comparatively assessed between the two groups.

Results: The percentages of reduction in SBP and DBP variables in the crystalloid solution were higher than those of the colloid group and the differences were statistically significant (P = 0.042 and P = 0.008, respectively). Average percentage of HR changes was more significant in the crystalloid than the colloid group (P = 0.032). In contrary, administration of the two types of solutions did not result in significant differences in the Apgar scores. The prevalence of nausea and vomiting in the colloid group subjects was lower than those of the crystalloid solution group; however, the differences were not significant.

Conclusions: The current study findings recommend colloid solution to prevent hemodynamic instability after spinal anesthesia. However, the costs and availability of the solution and recommendation of anesthesiologist should be considered. Conduction of further clinical trials with larger sample sizes is recommended.

Keywords: Cesarean Section; Colloid Solution; Crystalloid Solution; Hypotension; Spinal Anesthesia.

PubMed Disclaimer

References

    1. Foruzeshfard M, Validad E, Mirmohamadkhani M, Moradan S. [Type of anesthesia chosen by mothers for cesarean section in their first delivery and its related factors in selected hospitals in year 2012.]. Iran J Obstet Gynecol Infertil. 2013;15(39):1–8.
    1. Carvalho B, Cohen SE, Lipman SS, Fuller A, Mathusamy AD, Macario A. Patient preferences for anesthesia outcomes associated with cesarean delivery. Anesth Analg. 2005;101(4):1182–7. doi: 10.1213/01.ane.0000167774.36833.99. table of contents. - DOI - PubMed
    1. Hawkins JL. Epidural analgesia for labor and delivery. N Engl J Med. 2010;362(16):1503–10. doi: 10.1056/NEJMct0909254. - DOI - PubMed
    1. Bishop DG, Cairns C, Grobbelaar M, Rodseth RN. Heart rate variability as a predictor of hypotension following spinal for elective caesarean section: a prospective observational study. Anaesthesia. 2017;72(5):603–8. doi: 10.1111/anae.13813. - DOI - PubMed
    1. Ripolles Melchor J, Espinosa A, Martinez Hurtado E, Casans Frances R, Navarro Perez R, Abad Gurumeta A, et al. Colloids versus crystalloids in the prevention of hypotension induced by spinal anesthesia in elective cesarean section. A systematic review and meta-analysis. Minerva Anestesiol. 2015;81(9):1019–30. - PubMed

LinkOut - more resources