Maternal cardiac effect of Hydroxyethyl Starch (HES) using LiDCO in cesarean section

This study evaluated the maternal cardiac effect of hydroxyethyl starch(HES) solution when administrated preload or afterload in cesarean section under spinal anesthesia through minimally invasive arterial monitoring system LiDCO rapid. Sixty patients undergoing selective cesarean section, aged 20 to 30 years old, were randomly divided into pre-loading HES group (group P) and after-loading HES group (group A). Except a routine BP, ECG, SpO2 monitoring, every patient was connected to the LiDCO rapid (arterial pressure waveform analysis) to monitor CO. After establishing venous access, group P and group A were respectively administered a rapid intravenous infusion of 6% hydroxyethyl starch solution HES 130/0.4 250ml before or after spinal anesthesia within 5 min. The LiDCO monitoring system could record the indexes of heart rate (HR), cardiac output (CO), mean arterial pressure (MAP) and left ventricle stroke volume (SV) continuously. We compared these values at some time points and incidence of hypotension. Results Group P was significantly higher than group A in MAP,CO and SV at these time points including T1, T2 and T3 after spinal anesthesia (P<0.05). But it had not statistical difference in MAP, CO and SV at other points (P>0.05). There were no significant differences in HR between the two groups at all points(P>0.05). Phenylephrine requirements in group P were lower than group A(P<0.05). Conclusions Administering HES before spinal anesthesia could increase the CO, MAP, SV and prevent hypotension more effectively. So pre-loading fluid therapy might have more stable cardiac effect in cesarean section with spinal anesthesia.