Key result
Administration of Ringer's lactate half an hour before spinal anaesthesia for caesarean section did not significantly reduce the incidence of hypotension compared to administration over 6 hours (12.7% vs 25%).
Why the study?
Spinal anaesthesia-induced hypotension risks maternal and fetal life, motivating comparison of crystalloid administration timing before spinal anaesthesia to reduce hypotension.
Does administering Ringer's lactate half an hour before surgery compared to 6 hours before surgery reduce the incidence of hypotension in patients undergoing elective lower segmental caesarean section under spinal anaesthesia?
RCT (n=110)
Single-blind
randomly allocated
Does administering Ringer's lactate half an hour before surgery compared to 6 hours before surgery reduce the incidence of hypotension in patients undergoing elective lower segmental caesarean section under spinal anaesthesia?
Absolute Event Rate: 12.7% vs 25%
p-value: p=statistically insignificant
The timing of intravenous fluid preload (half an hour vs 6 hours before surgery) does not significantly affect the incidence of hypotension during spinal anesthesia for caesarean section.
No significant difference in hypotension with half-hour versus 6-hour preload; confirms timing is not critical and supports flexible preoperative fluid administration.
: Spinal anaesthesia-induced hypotension can be prevented by several techniques and methodologies, which is very important as the life of the mother and fetus is at risk. This study compared the efficacy of crystalloid administration 6 hours and half an hour before spinal anaesthesia on reducing hypotension. : After obtaining informed consent, 110 ASA 2 patients aged between 20 and 40 were scheduled for elective lower segmental caesarean section under spinal anaesthesia. Patients were randomly allocated into two groups. Group 1: Participants were kept nil per oral overnight, and Ringer's lactate was administered over half an hour before surgery. Group 2: participants were given ringer lactate. The amount was based upon the Holiday Segar formula (first 10 kg received 4ml/kg, 10-20 kg- 2ml/kg and remaining received 1 ml/kg) and given steadily over half an hour and 6 hours respectively in both groups. The incidence of hypotension and the need for rescue vasopressor in the two groups was recorded. : The two groups were statistically comparable in terms of age, height and weight. The incidence of Hypotension in Group 1 was 12.7%, and in Group 2 was 25%, which was statistically insignificant. Seven out of 55 patients in Group 1 had SBP<20% from baseline, whereas in Group 2, 14 patients out of 55 patients had SBP <20% from baseline, which was statistically insignificant. The incidence of ephedrine usage was statistically insignificant in both groups. : This study's results showed no statistically significant difference in preventing hypotension whether the fluids were given as 6 hours or half an hour before surgery. Therefore, to deliver preload of fluid, it is unnecessary to delay surgery.
No takes yet. Share an insight, caveat, or question.
Babu et al. (2023) conducted an RCT in Spinal anaesthesia-induced hypotension (n=110). Ringer's lactate administered over half an hour before surgery vs. Ringer's lactate administered steadily over 6 hours before surgery was evaluated on Incidence of hypotension (p=statistically insignificant). Administration of Ringer's lactate half an hour before spinal anaesthesia for caesarean section did not significantly reduce the incidence of hypotension compared to administration over 6 hours (12.7% vs 25%).
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: