Key result
Coloading with crystalloid resulted in a significantly higher minimum mean systolic blood pressure (100 vs 90 mm Hg, p=0.043) and required fewer vasopressor doses than preloading.
Why the study?
Spinal anaesthesia for lower segment caesarean section is associated with maternal hypotension, prompting a comparison of crystalloid preloading versus coloading for its prevention.
Does coloading with crystalloid prevent maternal hypotension better than preloading in parturients undergoing elective caesarean section under spinal anaesthesia?
RCT (n=50)
Double-blind
Computer-generated random number table
No
Does coloading with crystalloid prevent maternal hypotension better than preloading in parturients undergoing elective caesarean section under spinal anaesthesia?
Absolute Event Rate: 100% vs 90%
p-value: p=0.043
Coloading with crystalloid is more effective than preloading for preventing maternal hypotension during elective caesarean section under spinal anaesthesia.
Coloading may reduce hypotension and vasopressor needs vs preloading in elective LSCS; leaves open confirmation in larger trials.
Background: Spinal anaesthesia is now an established technique for lower segment caesarean section (LSCS) but is associated with maternal hypotension.We intended to compare the use of preloading vscoloading with crystalloid for prevention of same.Methods: Fifty parturients with American Society of Anesthesiologists' physical status 1 or 2 undergoing elective LSCS were recruited.Twenty five patients in group P (n =25) and group C (n =25) received 15 mL/kg of ringer lactate 20 minute before spinal anaesthesia and just after spinal anaesthesia respectively in both groups.Blood pressure and heart rate were recorded at 1 min interval starting 1 min after intrathecal injection till the first 10 min, every 5 min till the next 20 min and every 10 min thereafter till the end of the surgery.Data was tabulated using Microsoft excel (2010) and analyzed using the SPSS (version 8) software.Student's t-test was used for quantitative data and the Chi square test for qualitative data.Results: The minimum mean systolic blood pressure (SBP) values recorded in the two groups were 90 ± 12.5 mm Hg in group P and 100 ± 9.5 mm Hg in group C (P = 0.043) at 7 th and 6 th minute respectively.The mean number of doses of mephentermine were more in group P (1.56±0.234)compared to group C (0.75±0.452).(P< 0.0001).Conclusion: Coloading provides a better alternative than preloading for prevention of maternal hypotension secondary to spinal anaesthesia given for caesarean section.
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Dr Ankita Chandel (2020) conducted an RCT in Maternal hypotension during elective caesarean section under spinal anaesthesia (n=50). Coloading with crystalloid (Ringer lactate) vs. Preloading with crystalloid (15 mL/kg 20 minutes before spinal anaesthesia) was evaluated on Minimum mean systolic blood pressure (SBP) in mm Hg (p=0.043). Coloading with crystalloid resulted in a significantly higher minimum mean systolic blood pressure (100 vs 90 mm Hg, p=0.043) and required fewer vasopressor doses than preloading.
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