Hydroxyethyl Starches, Dextran and Balanced Salt Solution in Correction of Hypotension during Epidural Anaesthesia

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Abstract
A low MW (38,000) and a medium MW (125,000) hydroxyethyl starch and a medium MW dextran (70,000) solution were compared with a balanced salt solution in 123 patients undergoing operations of the lower extremities in epidural anesthesia; 500 ml of the studied solutions were infused during 15 min after the injection of the epidural anesthetic. The need for etilefrine hydrochloride as a vasoconstrictor in correcting hypotensive reactions was recorded. Changes in Hb, hematocrit (Hct), serum total protein and serum albumin concentrations were measured. The number of patients given etilefrine hydrochloride in the plasma-substitute groups was smaller than in the control group. The differences were, however, not statistically significant. The fall in blood pressure cannot be totally inhibited by administration of 500 ml plasma substitute. According to the differences in Hb, Hct, serum protein and albumin values, the hydroxyethyl starch solutions were significantly more effective plasma substitutes than the balanced salt solution and as effective as dextran. No side effects attributable to the solutions used were observed.