Comparative efficacy of crystalloid preloading and co-loading to prevent spinal anesthesia induced hypotension in elective caesarean section

Aim: to compare the efficacy of crystalloid preloading and co-loading for prevention of hypotension during spinal anesthesia for elective caesarean section. methods: this randomized clinical trial was conducted in department of anesthesiology,combined military hospital,quetta. study was carried out over a period of six months from july to december 2013. a total of 74 patients (37 in each group) were included in this study. patients with asa classification 1 &2,aged 18-40 years were included. patients with complicated pregnancy or failed spinal were excluded. group-p received crystalloid preload and group-c was given crystalloid co-load. blood pressure was recorded at 1,2,3,5,10 minutes. patients received vasopressors when systolic blood pressure dropped below 90 mmhg. results: total study population was 74 pregnant women underwent elective caesarean section. mean age of the patients was 28.38±5.07 years and 28.27±5.07 years in group-p and c,respectively. overall hypotension was noted in 23 patients (62.2%) of group-p and 18 patients (48.6%) of group-c. the difference between two groups was statistically insignificant (p=0.242). after induction of spinal anesthesia at 1 minute hypotension was noted in 6 patients (16.2%) of group-p and in 11 patients (29.7%) of group-b,at 2 minutes in 19 patients (51.4%) of group-a and in 20 patients (54.1%) of group-c,at 3 minutes in 21 patients (56.8%) of group-p and in 22 patients (59.5%) of group-c,at 5 minutes in 15 patients (40.5%) of group-p and in 16 patients (43.2%) of group-c,at 10 minutes in 11 patients (29.7%) of group-p and in 5 patients (13.5%) of group-c hypotension was developed. conclusion: both preloading and co-loading with 15 ml/kg of hartmann's solution (lactated ringer's solution),when used alone,are ineffective for the prevention of hypotension in the obstetric population receiving spinal anesthesia.