Key result
A 20 mL/kg crystalloid bolus before spinal anesthesia for cesarean delivery did not reduce the total metaraminol dose required up to uterine incision compared to no bolus (3.27 vs 3.62 mg, P=0.3).
Why the study?
Does a crystalloid bolus reduce the required dose of metaraminol to maintain arterial blood pressure during spinal anesthesia for cesarean delivery in women?
RCT (n=66)
Does a crystalloid bolus reduce the required dose of metaraminol to maintain arterial blood pressure during spinal anesthesia for cesarean delivery in women?
Absolute Event Rate: 3.27% vs 3.62%
p-value: p=0.3
A crystalloid bolus is not essential for maintaining arterial pressure during spinal anesthesia for cesarean delivery when sufficient metaraminol is given in the immediate postspinal period.
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Crystalloid preloading may be safely omitted with prompt metaraminol titration; challenges routine fluid bolus use in obstetric spinal anesthesia.
Kee et al. (2001) conducted an RCT in Elective cesarean delivery (n=66). Lactated Ringer's solution bolus vs. No bolus was evaluated on Total dose of metaraminol required up to the time of uterine incision (p=0.3). A 20 mL/kg crystalloid bolus before spinal anesthesia for cesarean delivery did not reduce the total metaraminol dose required up to uterine incision compared to no bolus (3.27 vs 3.62 mg, P=0.3).