A COMPARATIVE STUDY OF THE EFFECTS OF NORMAL SALINE AND HYDROXYETHYL STARCH 6% ON MOTHERS' BLOOD PRESSURE DURING SPINAL ANESTHESIA IN ELECTIVE CESAREAN SECTION

Introduction: Hypotension is the most common problem after spinal anesthesia in women volunteered for cesarean section. This complication can be prevented by hydrating the patient with a suitable and stable serum. The present study intended to compare the effects of normal saline and hydroxyethyl starch 6% on reducing hypotension in women volunteered for cesarean section after spinal anesthesia. Methodology: To this end, a clinical trial was conducted on 72 pregnant women who were volunteered for cesarean section in Shahid Motahari Hospital in Jahrom, Shiraz. The eligible patients were randomly divided into two groups of 36. Both the blood pressure and heart rate of patients were measured after entering the operating room and before spinal anesthesia. An amount of 15-20 cc normal saline per kilogram of body weight was injected intravenously to the patients of the first group about 15 minutes prior to spinal anesthesia while 5-10 cc of hydroxyethyl starch per kilogram of body weight was injected intravenously to the second group. Systolic and diastolic blood pressure as well as heart rate of the patients were measured within 5, 10 and 15 minutes after anesthesia and then every 10 minutes until the end of C-section operation. Data were analyzed in SPSS11 using Mauchly's Sphericity Test and Greenhouse-Geisser test. Results: Over time there was a statistically significant difference in the systolic and diastolic blood pressure between both groups and between the time and type serum (P<0.001). In case group (HES), the mean of baseline systolic blood pressure was 124.9 mmHg as well as 123.7 and 112.2 mmHg respectively 15 and 30 minutes after the operation. On the contrary, the mean of baseline blood pressure was 123.9 mmHg as well as 94.3 and 103 mmHg respectively 15 and 30 minutes after the operation in control group (NS). The incidence of hypotension was 11% in HES group and 25% in NS group. Conclusion: In addition to hypotension reduction, homodynamic instability was also lower in HES than NS group. However, there was not any significant difference in the heart rate and neonatal Apgar between both groups. Consequently, hydroxyethyl starch may be effective in preventing hypotension.