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Comparitive Evaluation of Crystalloid Preload and Crystalloid Coload on Hemodynamic Parameters in Patients Undergoing Elective Cesarean Section under Spinal Anesthesia

Sudharani P Halli , Divakar S Ramegowda , Sudharani P Halli , Shivakumar Gurulingaswamy , Subhasundari Visu , Sushma J Pattar , Sanchara M Paramesh

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Indian Journal of Anesthesia and Analgesia 7(2):p 449-458, Mar-Apr 2020. | DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.7220.2

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Divakar S Ramegowda, Sudharani P Halli, Shivakumar Gurulingaswamy, et al. Comparitive Evaluation of Crystalloid Preload and Crystalloid Coload on Hemodynamic Parameters in Patients Undergoing Elective Cesarean Section under Spinal Anesthesia. Indian J Anesth Analg. 2020;7(2):449–458.

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Abstract

Aims and Objectives: To compare the effects of crystalloid preload and crystalloid coload on hemodynamic parameters in patients undergoing elective cesarean section under spinal anesthesia. Materials and Methods: One hundred patients with American Society of Anesthesiologists Physical Status I and II scheduled for elective cesarean section under spinal anesthesia were randomly allocated into two groups with fifty patients each. Group P: Received 15 ml/kg of Ringer‘s lactate solution over 20 minutes prior to spinal anesthesia. Group C: Received 15 ml/kg of Ringer‘s lactate solution over 20 minutes as soon as Cerebrospinal fluid (CSF) was tapped. Patients were assessed for hemodynamic changes, mean and total dose of vasopressor consumption in the intraoperative period. Results: The incidence of Hypotension was high in Group P (66%) when compared to Group C (36%) with p - value of 0.0027 which is statistically significant. Hypotension appeared early in Group P (6.85 ± 0.83) when compared to Group C (15.83 ± 0.92) minutes with significant 
p - value of < 0.001. Group P also had higher incidence of nausea and vomiting (48% and 34%) when compared to Group C (18% and 12%) respectively with statistically significant difference. (p - value 0.0027 and 0.0014 respectively). The incidence of bradycardia and shivering was also high in Group P as compared to Group C though the difference is statistically insignificant. Conclusion: Crystalloid coload in the dose of 15 ml/kg is more effective than the crystalloid preload in the same dose for prevention of spinal hypotension in patients undergoing elective cesarean section.

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Divakar S Ramegowda, Sudharani P Halli, Shivakumar Gurulingaswamy, et al. Comparitive Evaluation of Crystalloid Preload and Crystalloid Coload on Hemodynamic Parameters in Patients Undergoing Elective Cesarean Section under Spinal Anesthesia. Indian J Anesth Analg. 2020;7(2):449–458.

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DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.7220.2

Keywords

Crystalloid preload; Crystalloid coload; Elective cesarean section; Hemodynamic changes; Mean and total vasopressor consumption.

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