Hydroxyethylstarch 6% preload does not prevent the hypotension following induction with propofol and fentanyl

To study the effects of volume preload with hydroxyethylstarch 6% (HES) on the changes in arterial blood pressure and heart rate following propofol/fentanyl induction of anesthesia.

Seventy five patients, divided into three groups, scheduled for orthopedic surgery were allocated randomly to receive either no preload or 500 ml, or 1000 ml of 6% HES respectively over 20 minutes period prior to anesthetic induction. Anesthesia was induced with fentanyl 1.5 microg.kg(-1) and propofol 2.5 mg.kg(-1). Cardiovascular parameters were monitored for 5 minutes following induction.

Systolic blood pressure (SBP) decreased significantly (P<0.001) in all groups after anesthetic induction. Blood pressure recorded at 5 minutes was 76% of the baseline values in the control group and in the HES 500 group and was 78% in the HES 1000 group. Changes in the diastolic blood pressure (DBP) and mean blood pressure (MBP) were also similar in the three groups. There was no significant difference between the three groups in the HR decline too.

Administration of 6% HES as a preload did not attenuate the decrease in blood pressure following induction of anesthesia with propofol and fentanyl.