Document Type : Original Article (s)
Authors
1
Anesthesiologist, Isfahan University of Medical Sciences, Isfahan, Iran
2
Associate Professor, Department of Anesthesia and Critical Care, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
Abstract
Background: Colloids play an important role in fluid resuscitation. However, their unfavorable effects on the coagulation system have led to the limited usage of these solutions. Newer types of colloids are currently being claimed to have minimal effects on homeostasis. This study tried to evaluate such a claim.Methods: In a double blind clinical trial, 58 ASA (American Society of Anesthesiologists) I and II patients candidate for elective lower limbs or lower abdomen surgeries under spinal anesthesia were studied. Using thromboelastography, the coagulation system was evaluated before and 1 hour after an infusion of 15 cc/kg of hydroxyethyl starch (HES) 130 in the study group and HES 200 in the control group. Hemodynamics were monitored and recorded during the study and data was analyzed by chi-square test, analysis of variance (ANOVA) and Mann-Whitney test at a significance level of 0.05.Findings: Mean age in the study and control groups were 37.83 ± 16.1 and 44.07 ± 15.6 years, respectively. There were 23 males and 6 females in each group. Mean weight in the study and control groups were respectively 69.48 ± 8.7 and 69.72 ± 7.5 kg. The results of statistical analyses did not show any differences in these three variables. Repeated measures ANOVA only revealed P values less than 0.05 for heart rate and body temperature. However, the patients were not significantly different in blood pressure. Mean values of thromboelastography parameters, including R (reaction time), K (coagulation time), α (angle), MA (maximal amplitude), and LY30 (percentage lysis 30 minutes post-MA) did not have significant differences between the two groups after infusion of starches. Conclusion: The patients had similar hemodynamic indexes during the study. They did not show any significant differences in thromboelastography parameters (R, K, α, MA, and Ly30). Therefore, 15 cc/kg of HES 130 does not have any priority over HES 200 for effects on coagulation.
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