Publication:

Comparison of preload versus coload by crystalloid in parturients undergoing caesarean section under spinal anaesthesia: an analytical study

Background Spinal anesthesia is popular, simple and well accepted reliable technique for below umbilicus surgery. It is frequently used for lower segment section because of its rapid onset, a dense neural block, avoidance of risk of airway, little risk of local anesthetic toxicity and minimal transfer of drug to the fetus, as well as little risk of failure of block. Objectives of this study was to compare incidence and severity of hypotension, dose requirement of mephentermine and maternal bradycardia, shivering, nausea, vomiting.

Methods ASA grade I, II parturients posted for elective cesarean section were randomly allocated in two study groups of 55 each to receive either preload or co-load with Ringers lactate solution, blood pressure, heart rate, mephentermine requirement and other outcomes recorded at regular interval.

Results Hypotension was observed significantly less in co-loading group (37.18%) than preloading group (61.81%). Mean vasopressor requirement was also significantly more in preload group. Heart rate change, nausea, vomiting and fetal outcome remained same across both the groups.

Conclusions Co-loading with crystalloids is more effective strategy than preloading in prevention of spinal induced hypotension. We can save valuable time given for preloading in case of emergency caesarean sections.