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Abstract PR219: Crystalloid Or Colloid for Goal-Directed Fluid Therapy in Cesarean Section Under Combined Spinal Epidural Anesthesia

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Abstract

Background & Objectives: It is still controversial that what kind of fluid is optimal to prevent hypotention during combined spinal epidural anesthesia(CSEA) for cesarean section. Goal-directed fluid therapy(GDFT), as an effective way of fluid therapy, has more sense in choosing the optimal type of i.v. fluid than normal fluid therapy. This study will compare crystalloid to colloid forGDFT in cesarean section under CSEA to discuss which type of i.v. fluid is more effective to prevent perioperative hypotention.
Materials & Methods: This study was performed in Shengjing Hospital of China Medical University, Shenyang. We randomly assigned 60 patients (ASA I-II) scheduled undergoing cesarean section into two groups.The colloid group received balanced 6% HES (130/0.4, Volulyte,) and Lactated Ringer’s solution (LR), while the crystalloid group just received LR as haemodynamic optimization fluid. The primary outcomes included the incidence of maternal hypotension, and vasopressor doses prior to delivery. The secondary outcomes included umbilical blood gas abnormalities, neonatal Apgar grade and adverse events.
Results: Patients in crystalloid group received more fluid than those in colloid group.No statistical difference was seen of the number of patients who showed hypotension, vomiting and nausea between two groups. And there was no significant difference of the incidence of neonatal adverse effects between two groups.
Conclusion: No evidence showed that colloid had more advantages in GDFT for patients received cesarean section under CSEA, except that the volume of colloid input was less than crystalloid.
References:
1. Mercier F J, Diemunsch P, Ducloy Bouthors A S, et al. 6% Hydroxyethyl starch (130/0.4) vs Ringer’s lactate preloading before spinal anaesthesia for Caesarean delivery: the randomized, double-blind, multicentre CAESAR trial[J]. British journal of anaesthesia, 2014, 113(3): 459-467.
2. Yates D R A, Davies S J, Milner H E, et al. Crystalloid or colloid for goal-directed fluid therapy in colorectal surgery[J]. British journal of anaesthesia, 2014, 112(2): 281-289.

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