Comparative Evaluation of Preloading and Coloading of Crystalloids to Prevent Spinal Induced Hypotension in Caesarean Section
Journal Title: International Journal of Contemporary Medical Research - Year 2017, Vol 4, Issue 2
Abstract
Introduction: Most routine and emergency caesarean sections are done under spinal anaesthesia because it is a safe, quick in onset and reliable technique. Maternal hypotension is most common cardiovascular response of spinal anaesthesia that can lead to nausea, vomiting and cardiovascular collapse in mother and hypoxia in neonate. Administration of crystalloids before spinal block have been common practice to prevent hypotension. But some investigators have questioned the efficacy of preloading. We conducted this study to compare effectiveness of preloading and coloading in prevention of spinal anaesthesia induced maternal hypotension during caesarean section. Material and Methods: 60 parturients, ASA physical status of I and II, uncomplicated pregnancy posted for caesarean section under spinal anaesthesia were randomized into two group. Preload group received 15 ml/kg of RL solution over 20 min and coload group were given same volume of RL solution over 20 min after CSF tapping. Hypotension was defined as a decrease in systolic blood pressure of more than 20% from the baseline or a decrease of systolic blood pressure to less than 90 mmHg as absolute value. Episodes of hypotension were treated with fluid boluses and inj. Ephedrine. Results: Incidence of hypotension was 40% in preload group and 46.66% in coload group, which was statistically not significant (p=0.602).Incidence of nausea and vomiting, vasopressor requirement and neonatal outcome were comparable in both groups. Conclusion: Coloading with crystalloids is equally effective as preloading to prevent spinal anaesthesia induced maternal hypotension.
Authors and Affiliations
Parul Jain, Deepali Valecha
Keywords
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