Infusion support with a metabolic component solution during abdominal delivery under spinal anesthesia
The aim of the study was to evaluate the efficacy, safety, and the benefits of a combined mode of volumetric support with a metabolic component solution for the mother and fetus in cesarean section under spinal anesthesia. Material and methods. The study included 80 patients divided into 2 groups: in the main group (n = 40), polyoxyfumarin was used for volumetric support, in the control group (n = 40) - Gelofusin. Injection for 5 minutes (40 ml / min) followed by postinfusion 12-18 ml / min until the end of the operation. Results. Episodes of hypotension (BPsys <100mm Hg) in the main group were noted in 30.0%, in the control group - in 62.5%, phenylephrine boluses were needed in 20.0% and 52.5% of cases, respectively. Volumetric effect after preinfusion was significantly higher in patients of the main group. The impact and MOC increased more significantly also in the patients of the main group. When analyzing pH, pO2, pCO2, lactate from the umbilical artery, there was no difference between the groups, as in the Apgar score for newborns. Conclusions. Volumetric support with polyoxyfumarin is an effective and safe procedure for both the mother and the fetus for caesarean section under spinal anesthesia, smoothly stabilizes hemodynamics, reduces the number of episodes of hypotension (up to 30%) and reduces the use of vasopressors (up to 20%). Unidirectional changes in the indices of central hemodynamics and bioelectrical activity of the heart were revealed with the use of both blood substitutes with a greater need for vasopressors with the support of Gelofusin. There were no significant differences in the main indicators of newborns in the study groups.