THE EFFECT OF HYPEROSMOLAR CRYSTALLOID SOLUTIONS ON THE HEMODYNAMICS OF PATIENTS DURING CESAREAN SECTION UNDER CONDITIONS OF SPINAL ANESTHESIA

Today, in most cases, the caesarean section is performed under spinal anesthesia. It has several advantages for cesarean section, but it also has several disadvantages. An important disadvantage is hypotension, which requires the use of vasopressors. The aim of the study was to assess the effect of the hyperosmolar crystalloid solution Reosorbilact on hemodynamics during cesarean section under spinal anesthesia. In the period from February to April 2019, we conducted a study of the efficacy of Reosorbilact in patients with elective caesarean sections under spinal anesthesia, which were two groups of 84 patients each. The composition of infusion therapy was standardized in patients of the both groups. The patients of the control group received an infusion of 1200 ml of isotonic crystalloids, and the patients of the studied group received 1000 ml of isotonic crystalloids and 200 ml of Reosorbilact solution. In addition to monitoring standard parameters, the hemodynamic monitoring included a non-invasive measurement of cardiac output using the esCCO method. In case of hypotension, phenylephrine was administered with dose adjustment according to the effect. The introduction to the infusion program during elective caesarean section under the conditions of spinal anesthesia of the hyperosmolar crystalloid solution Reosorbilact resulted in a significant reduction of the severity of adverse hemodynamic effects. Maintaining a significantly more stable hemodynamics and reducing the need for vasopressors were achieved without an increase in total infusion. The results obtained demonstrate the possibility of maintaining stable hemodynamics against the background of restrictive infusion during caesarean section under spinal anesthesia. The decrease in cardiac output, developing on the background of spinal anesthesia in caesarion section, was significantly less pronounced. In general, Reosorbilact during cesarean section under spinal anesthesia proved to be an effective means of maintaining stable hemodynamics while maintaining a restrictive volume of infusion therapy.

caesarean section, pregnancy, spinal anesthesia, infusion therapy, hyperosmolar solutions, hemodynamics

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