Crystalloid PreloadVsCrystalloid Coloadfor the Prevention of Hypotension During Spinal Anesthesia

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Crystalloid PreloadVsCrystalloid Coloadfor the Prevention of Hypotension During Spinal Anesthesia

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Introduction: Hypotension following Spinal Anesthesia (SA) is a common and troublesome Complication. Prophylactic fluid preloading with crystalloids is traditional practice to prevent hypotension. Timing of the infusion of the crystalloid is more important as its shorter intravascular stay. We hypothesized that crystalloid loading just after intrathecal injection compared to preload is more effective. Methods: 100 healthy adult patients of ASA 1 & 2, scheduled to undergo lower limb and abdominal surgery under spinal anesthesia, were studied. Patients in preload Group (A) were preloaded with RL at 15 ml/kg over 20 min periods prior to spinal anesthesia while in coload Group (B) received Ringer lactate 15 ml/kg as soon as spinal block is performed over 10 to 15 min. Results: The incidence of hypotension was low in coload group than compared to preload group. Mean arterial pressure at before spinal anesthesia was 100 mm Hg and 101 mm Hg, following subarachnoid block at 3 minutes dropped up to 85 mm Hg and 92 mm Hg, after 5 minutes 80 mm Hg and 88 mm Hg after 10 minutes 78 mm Hg and 90 mm Hg in preload and coload group respectively. Conclusions: In our study, we found that coload is more effective, than preload solution in prevention of hypotension in patients undergoing elective surgeries for abdomen and lower limb surgery under spinal anesthesia. So, it is unnecessary to spend time to deliver preload and delay surgery for the prevention of SA induced hypotension.

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