Comparing Lactated Ringer's and Hydroxyethyl Starch Preloading to Prevent Hypotension in Caesarean Section Spinal Anaesthesia: A Clinical Study

Dr Kangkan Sharma

Abstract: This prospective, randomized study compared the efficacy of 500 mL 6% hydroxyethyl starch (HES 130/0.4) versus 1 L Lactated Ringer?s (RL) solution as preloading fluids to prevent hypotension in 150 non - laboring ASA I and II women undergoing elective caesarean section under spinal anaesthesia. Patients were randomly assigned to receive either HES (Group A) or RL (Group B) before anaesthesia, with blood pressure monitored at regular intervals up to 60 minutes post - spinal block. Hypotension, defined as a systolic drop >30% or <90 mmHg, was managed with RL infusion and mephentermine boluses. Results showed hypotension in 17.33% of Group A versus 33.33% of Group B (p=0.0381), with Group A requiring significantly less mephentermine. We conclude that HES 130/0.4 outperforms RL in preventing hypotension, suggesting its potential for routine use.

Keywords: Hydroxyethyl Starch, Ringer Lactate. Caesarean Section. Spinal Anaesthesia, Hypotension