Prevention of Hypotension after Spinal Anesthesia for Transurethral Resection of the Prostate Using 6% Hetastarch versus Lactated Ringer's Solution

Objective: To compare the use of 6% Hetastarch with Lactated ringer's solution for prevention of hypotension after spinal anesthesia for transurethral resection of the prostate. Methods: In a randomized double blind study, 60 patients who underwent subarachnoid anesthesia for transurethral surgery were divided into two equal groups: group A were given Lactated ringer's solution and group B were given 6% Hetastarch. One thousand ml of Lactated ringer's solution for group A and 500 ml of 6% Hetastarch for group B was started to be administered intravenously to patients 10 minutes before the administration of the spinal anesthesia. Heart rate, blood pressure and oxygen saturation were recorded prior to, during and after surgery. Also the incidence of nausea and vomiting and the use of ephedrine were recorded. Results: The incidence of hypotension was higher in group A (83%) than in group B (43 %). Systolic blood pressure < 90 mmHg occurred in 25 patients out of 30 who received Lactated ringer's solution compared to 13 patients who received Hetastarch. More patients required ephedrine to treat hypotension in group A than in group B. Nausea or vomiting was lower in group B also. Conclusion: Six percent Hetastarch is superior to Lactated ringer's solution for prevention of hypotension after spinal anesthesia for transurethral resection of the prostate.