TY - JOUR
T1 - Effect of crystalloid and colloid preloading on uteroplacental and maternal haemodynamic state during spinal anaesthesia for Caesarean section
AU - Karinen, J.
AU - Rasanen, J.
AU - Alahuhta, S.
AU - Jouppila, R.
AU - Jouppila, P.
N1 - Copyright:
Copyright 2018 Elsevier B.V., All rights reserved.
PY - 1995
Y1 - 1995
N2 - We have studied the effects of crystalloid 1 litre (lactated Ringer's) or colloid 0.5 litre (hydroxyethyl starch) preloading in 26 healthy parturients undergoing elective Caesarean section under spinal anaesthesia. Maternal placental uterine artery circulation was measured using a pulsed colour Doppler technique with simultaneous measurement of maternal haemodynamics. A high incidence of maternal hypotension was observed during spinal anaesthesia in the crystalloid group (62%) but the incidence was lower in the colloid group (38%). Central venous pressure was increased significantly in both groups after preload but decreased shortly after induction of spinal anaesthesia to baseline values. The mean pulsatility index (PI) in the uterine arteries did not change during preload or spinal block. A surprising finding was the widespread variation and some high values for the uterine artery PI after spinal anaesthesia. These individual increases in PI were transient and always returned to baseline values within 2 min. These results suggest that preloading with either solution is ineffective in preventing maternal hypotension and that changes in maternal heart rate, systolic arterial pressure and central venous pressure during spinal anaesthesia were not associated with rapid individual increases in uteroplacental vascular resistance. These changes seemed not to have any major effect, however, on the clinical condition of the newborn, as assessed by Apgar scores and umbilical artery pH values.
AB - We have studied the effects of crystalloid 1 litre (lactated Ringer's) or colloid 0.5 litre (hydroxyethyl starch) preloading in 26 healthy parturients undergoing elective Caesarean section under spinal anaesthesia. Maternal placental uterine artery circulation was measured using a pulsed colour Doppler technique with simultaneous measurement of maternal haemodynamics. A high incidence of maternal hypotension was observed during spinal anaesthesia in the crystalloid group (62%) but the incidence was lower in the colloid group (38%). Central venous pressure was increased significantly in both groups after preload but decreased shortly after induction of spinal anaesthesia to baseline values. The mean pulsatility index (PI) in the uterine arteries did not change during preload or spinal block. A surprising finding was the widespread variation and some high values for the uterine artery PI after spinal anaesthesia. These individual increases in PI were transient and always returned to baseline values within 2 min. These results suggest that preloading with either solution is ineffective in preventing maternal hypotension and that changes in maternal heart rate, systolic arterial pressure and central venous pressure during spinal anaesthesia were not associated with rapid individual increases in uteroplacental vascular resistance. These changes seemed not to have any major effect, however, on the clinical condition of the newborn, as assessed by Apgar scores and umbilical artery pH values.
KW - Anaesthesia, obstetric
KW - Anaesthetic techniques, subarachnoid
KW - Blood, flow, feto-uteroplacental
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U2 - 10.1093/bja/75.5.531
DO - 10.1093/bja/75.5.531
M3 - Article
C2 - 7577275
AN - SCOPUS:0028871671
SN - 0007-0912
VL - 75
SP - 531
EP - 535
JO - British journal of anaesthesia
JF - British journal of anaesthesia
IS - 5
ER -