Comparison of Ringer’s Lactate and 6% Pentastarch as a Preload for Subarachnoid Block in Parturient undergoing Lower Segment Caesarean Section

Abstract

BACKGROUND
Delivery by caesarean section is common in recent times and subarachnoid block is the technique of choice due to its simplicity and reliability. However, it can cause hypotension which is associated with increased morbidity and mortality. Preloading the parturient with colloid is more effective than crystalloid in preventing the hypotension. Among the commercially available colloids 6% Pentastarch in 0.9% saline has the best safety profile. In this study, we compared the efficacy of 10ml/kg Ringer’s lactate to that of 10ml/kg 6% Pentastarch in preventing the incidence and severity of hypotension in parturients undergoing LSCS under SAB.
MATERIAL AND METHODS
After the ethical committee's approval, a randomized study was conducted on 114 parturients (aged between 20 -32 years) and divided into two groups. Group P - 6% Pentastarch 10ml/kg IV and Group R - Ringer’s Lactate 10ml/kg IV. Study drugs were administered intravenously over 20 minutes before the performance of the subarachnoid block. HR, SBP, DBP, MAP and SPO2 were noted every minute for the first 10 minutes, thereafter for every 5 mins till the end of surgery.
RESULTS
The mean HR of group P was better maintained than that of group R. A statistically significant fall in SBP was seen with group R more than group P at the 2nd, 4th, 6th, 7th, 10th and 40th minute. Group P had significantly less fall in DBP and MAP than group R.
CONCLUSION
Our study demonstrates that 6% Pentastarch is better preloading fluid than Ringer’s lactate in preventing hypotension in parturients undergoing elective caesarean section under subarachnoid block.