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

Pawan Kumar Bairwa; Rajeev Sharma; Dharmpal Atal; Mahendra Kumar Verma

doi:10.18203/2320-6012.ijrms20232084

Authors

Pawan Kumar Bairwa Department of Anesthesilogy SMS Medical College and Hospitals, Jaipur, Rajasthan, India
Rajeev Sharma Department of Anesthesilogy SMS Medical College and Hospitals, Jaipur, Rajasthan, India
Dharmpal Atal Department of Anesthesilogy SMS Medical College and Hospitals, Jaipur, Rajasthan, India
Mahendra Kumar Verma Department of Community Medicine RVRS Government Medical College Bhilwara, Rajasthan, India https://orcid.org/0000-0002-9698-3069

DOI:

https://doi.org/10.18203/2320-6012.ijrms20232084

Keywords:

Caesarean section, Crystalloid, Preload and co-load, Spinal hypotension

Abstract

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.

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