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Comparative evaluation of co-loading versus preloading for prevention of post-spinal hypotension in elective caesarean section

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Original Article

Author Details : Aparna G. Kulkarni, Omshubham Asai, Abhimanyu S. Tarkase

Volume : 3, Issue : 3, Year : 2016

Article Page : 340-346

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Abstract

Aims and Objectives: The aim of the present study was to study the effectiveness of co-loading of crystalloid over preloading of crystalloid in prevention of maternal hypotension during spinal anaesthesia for elective caesarean section.
Material and Methods: Hundred parturients aged 18-35 yrs undergoing elective caesarean section were randomly allocated in two groups of fifty each. Group P received preload of 20ml/kg of ringer’s lactate solution over a period of 20 minutes before spinal anaesthesia, while Group C received co-load of 20ml/Kg of ringer’s lactate solution at the maximal possible rate by pressurized giving set at the time of administration of spinal anaesthesia. Both the groups received spinal anaesthesia using 2ml of 0.5% hyperbaric bupivacaine at L3-4 level with 23G Quinke’s spinal needle. Blood pressure measurements were recorded in both the groups at 2min interval from the start of the regional block for the first 10 min and then at 5min interval till 30min and thereafter every 15min till the end of surgery. Similarly other parameters like heart rate, SPO2, maximum level of sensory block and APGAR scores were also recorded.
Statistical Analysis: Chi-square test was used to find the significance of study parameters on categorical scale between groups. Z test was used to find the significance of study parameters on continuous scale between two groups (intergroup analysis) on metric parameters. Significance was assessed at 5 % level of significance. Any p – value less than 0.05 (p<0.05) and 0.01 (p<0.01) is considered as significant and highly significant respectively.
Results: Demographic data was comparable in both the groups. The baseline systolic blood pressure was comparable in both the groups and the difference was not statistically significant. The fall in blood pressure was more in Gr. P than in Gr. C at 5 to 30 min after administration of spinal anaesthesia and this difference was statistically significant. (P <0.05) Similarly the incidence of hypotension was more in Gr. P (72%) than Gr. C (23%) and this difference was also statistically significant. There was no statistically significant difference in the other parameters like heart rate, SPO2 and APGAR score in both the groups.
Conclusion: Co-loading of crystalloids lowers the incidence of hypotension than preloading after spinal anaesthesia for elective caesarean section.

Key Words: Co-loading, Crystalloid, Hypotension, Preloading, Spinal anaesthesia

How to cite : Kulkarni A G, Asai O, Tarkase A S, Comparative evaluation of co-loading versus preloading for prevention of post-spinal hypotension in elective caesarean section. Indian J Clin Anaesth 2016;3(3):340-346

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