Crystalloid preload versus crystalloid co-load for hypotension in parturients undergoing caesarean section under spinal anaesthesia

Aradhana Devi, Mekha Elizabeth, Olvyna D'Souza

MGM Medical College, Navi Mumbai, India

ABSTRACT

Though hypotension is a common complication after spinal anaesthesia, preloading with crystalloids may not be able to prevent it. We aimed to compare the efficacy of crystalloid preload and co-load for the prevention of maternal hypotension in parturients undergoing caesarean section under spinal anaesthesia. Seventy parturients, aged 20 to 40 years of American Society of Anaesthesiologist (ASA) physical status 1/II, scheduled for caesarean section under spinal anaesthesia were divided into two groups. Parturients in group P received 15 ml/kg of ringer's lactate as preload over 20 min before the intrathecal drug administration. Parturients in group C received 15 ml/kg of ringer's lactate over 20 min, just after intrathecal drug administration. Incidence of hypotension, systolic blood pressure, diastolic blood pressure, mean arterial pressure, heart rate, the requirement of ephedrine, and any complications was recorded. 25 (71%) parturients in group P and 15 (42%) parturients in group C developed statistically significant hypotension. 21 (59%) parturients developed nausea and vomiting in group P as compared to 9 (25%) parturients in group C which were statistically significant. The mean number of doses of ephedrine required in group P was 1.8±0.6 and 0.9±0.7 in group C which was statistically significant. The total dose of ephedrine used in group P was 9.6±3.4mg and 5.9± 2.1mg in group C which was statistically significant. Co-loading with 15 ml/ kg of crystalloid-like ringer's lactate was more effective than preloading in preventing spinal-induced maternal hypotension, thereby reducing ephedrine requirement and avoiding complications.

Keywords:

Anaesthesia, Co-load, Hypotension, Preload, Spinal, Caesarean section