Precarga con coloides vs cristaloides para prevenir la hipotensión materna en pacientes sometidas a cesárea bajo anestesia espinal en el Hospital Vicente Corral Moscoso, Cuenca 2013

Abstract

Introduction: Spinal anesthesia for cesarean section can cause severe maternal hypotension with decreased cardiac output and placental blood flow. The preload with fluids is essential to increase blood volume and decrease the risk of hypotension. Objective: To compare the incidence of hypotension caused by spinal block using a preload of 10 ml / kg of crystalloid vs 10 ml / kg of colloids in cesarean sections. Material and methods: A randomized controlled trial single-blind with 180 maternal divided into two equal groups was performed. Group A (n = 90) received a colloid preload (polygeline 3.5%) 10 ml / kg vs group B (n = 90) received Ringer's lactate solution 10 ml / kg 10 minutes before spinal anesthesia with 12.5mg hyperbaric bupivacaine. The incidence of hypotension, hemodynamic changes, side effects, compared vasopressors. Results: The incidence of maternal hypotension in the colloid group was 10.0% and in the crystalloid group was 67.8%. Vasopressor was used in 7.8% of patients in the colloid group and 44.4% in the crystalloid group. There are significant differences in systolic and diastolic blood pressure of the study groups. A greater number of adverse effects in the crystalloid group were recorded. Patients receiving colloids have a lower risk of adverse events, RR: 0.112 (95% CI: 0044-0285), p-value = 0.000. Conclusions: The colloids are superior preventing maternal hypotension, less need for vasopressors and fewer adverse events