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Prevention of hypotension after spinal anesthesia for cesarean section: dextran 40 versus lactated Ringer's solution
1Department of Anesthesiology, National Taiwan University Hospital, Taipei, R.O.C.
Background:
This study was designed to compare the efficacy of 10% dextran 40 with lactated Ringer's (LR) solution in reducing the incidence and severity of hypotension after spinal anesthesia for Cesarean section.
Methods:
Sixty ASA grade I patients scheduled for Cesarean section were randomized into two groups in a double-blind fashion to receive either 500 ml of dextran 40 or 1000 ml of LR solution prior to induction of spinal anesthesia.
Results:
The incidence of hypotension was 16 in 30 (53.3%) in the LR solution group and 8 in 30 (26.7%) in the dextran group (P < 0.05). The required dose of ephedrine for treatment of hypotension was significantly greater in the LR solution group than in the dextran group (15.5 mg versus 3.2 mg, P < 0.05). Neonatal outcome, as determined by Apgar score, was good and similar in both groups.
Conclusions:
We concluded that 500 ml of dextran 40 is more effective than 1000 ml of lactated Ringer's solution in reducing the incidence of hypotension induced by spinal anesthesia.