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Crystalloid Preload Versus Crystalloid Co-load During Elective Caesarean Section
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Why is it important?
Background and Aim: Spinal anesthesia is a preferred technique of anesthesia for pregnant women undergoing caesarean section. The major disadvantage with this technique is maternal hypotension which carries the greatest risk to mother and foetus. This study was designed to analyse various advantages and disadvantages associated with crystalloid preloading and co-loading during spinal anesthesia. Methods: Hundred parturients aged 20 to 40 years of physical status ASA I and II undergoing elective caesarean section under SAB were divided into two groups with 50 patients in each group. In Crystalloid Preload group, 15 ml/kg of Ringer lactate (RL) was preloaded 20 minutes before spinal anesthesia. In Co-load group, 15 ml/kg of RL was coloaded 20 minutes just after lumbar puncture. Vital parameters were noted before and after giving spinal anesthesia. Results: The occurence of hypotension (SBP < 100 mmHg) in Group P is 30% and 20% in Group C which is statistically insignificant (p = 0.35). The incidence of nausea is 8% & 6% in group P & group C respectively (p = 0.69). The incidence of vomiting is 2% in group P & 4% in group C (p = 0.55). Mephentermine was used in 19 patients in Group P & 13 patients in Group C which is statistically insignificant. Conclusion: Both preloading and co-loading with RL have similar effect on occurence of hypotension in pregnant women receiving spinal anesthesia. Precious time need not be wasted in preloading. Periodic measurement of BP in parturients for early detection of hypotension and administration of vasopressors for maintaining BP close to baseline can ensure better outcome.
Perspectives
Background and Aim: Spinal anesthesia is a preferred technique of anesthesia for pregnant women undergoing caesarean section. The major disadvantage with this technique is maternal hypotension which carries the greatest risk to mother and foetus. This study was designed to analyse various advantages and disadvantages associated with crystalloid preloading and co-loading during spinal anesthesia. Methods: Hundred parturients aged 20 to 40 years of physical status ASA I and II undergoing elective caesarean section under SAB were divided into two groups with 50 patients in each group. In Crystalloid Preload group, 15 ml/kg of Ringer lactate (RL) was preloaded 20 minutes before spinal anesthesia. In Co-load group, 15 ml/kg of RL was coloaded 20 minutes just after lumbar puncture. Vital parameters were noted before and after giving spinal anesthesia. Results: The occurence of hypotension (SBP < 100 mmHg) in Group P is 30% and 20% in Group C which is statistically insignificant (p = 0.35). The incidence of nausea is 8% & 6% in group P & group C respectively (p = 0.69). The incidence of vomiting is 2% in group P & 4% in group C (p = 0.55). Mephentermine was used in 19 patients in Group P & 13 patients in Group C which is statistically insignificant. Conclusion: Both preloading and co-loading with RL have similar effect on occurence of hypotension in pregnant women receiving spinal anesthesia. Precious time need not be wasted in preloading. Periodic measurement of BP in parturients for early detection of hypotension and administration of vasopressors for maintaining BP close to baseline can ensure better outcome.
Red Flower Publication Publications
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This page is a summary of: Crystalloid Preload Versus Crystalloid Co-load During Elective Caesarean Section Under Spinal Anesthesia, Indian Journal of Anaesthesia and Analgesia, January 2019, Red Flower Publication Private, Ltd.,
DOI: 10.21088/ijaa.2349.8471.6419.45.
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