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Hydroxyethyl starch 130/0.4 versus crystalloid co-loading during general anesthesia induction: a randomized controlled trial

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Abstract

Purpose

Hypotension and decreased cardiac output (CO) are common adverse effects during anesthesia induction depending on the patient’s pre-anesthetic cardiac condition. The aim of this study was to assess the ability of hydroxyethyl starch (HES) 130/0.4 to prevent hypotension and decreased CO during the induction of general anesthesia.

Methods

Ninety patients undergoing laparoscopic surgery were randomly divided into a HES group and a crystalloid group. Following the insertion of an intravenous line, fluid was administered to each patient at a rate of 25 ml/min using either crystalloid or HES 130/0.4. Five minutes after the initiation of fluid loading, anesthesia was induced using propofol (1.5 mg/kg), rocuronium (0.9 mg/kg), and remifentanil (0.3 mcg/kg/min). Tracheal intubation was performed 5 min after the induction of anesthesia. Following tracheal intubation, general anesthesia was maintained using remifentanil and sevoflurane. Non-invasive blood pressure (BP) level was measured at 1-min intervals and CO was measured continuously using electrical cardiometry from the start of fluid loading until 5 min after tracheal intubation.

Results

The number of patients with hypotension (systolic BP < 90 mmHg or 80% of baseline) was significantly lower in the HES group (p < 0.001) than in the crystalloid group. Patients in the HES group showed smaller CO decreases than did patients in the crystalloid group (p < 0.001). The Kaplan–Meier method showed a lower incidence and significantly slower onset of hypotension in the HES group (p = 0.009). Multivariate logistic regression models indicated that the use of HES is an independent factor for the prevention of both hypotension and decreased CO (below 85% of baseline; p < 0.005 for both).

Conclusions

Co-loading using HES 130/0.4 prevented hypotension and decreased CO during general anesthesia induction.

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Authors and Affiliations

  1. Department of Anesthesiology, Osaka City University Graduate School of Medicine, 1-5-7 Asahimachi, Abenoku, Osaka, 545-8586, Japan

    Takashi Juri, Koichi Suehiro, Shigemune Kuwata, Sayaka Tsujimoto, Akira Mukai, Katsuaki Tanaka, Tokuhiro Yamada, Takashi Mori & Kiyonobu Nishikawa

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  1. Takashi Juri
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  2. Koichi Suehiro
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  3. Shigemune Kuwata
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  4. Sayaka Tsujimoto
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  5. Akira Mukai
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Correspondence to Koichi Suehiro.

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Juri, T., Suehiro, K., Kuwata, S. et al. Hydroxyethyl starch 130/0.4 versus crystalloid co-loading during general anesthesia induction: a randomized controlled trial. J Anesth 31, 878–884 (2017). https://doi.org/10.1007/s00540-017-2416-1

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  • DOI: https://doi.org/10.1007/s00540-017-2416-1

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