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A randomized controlled trial to compare crystalloid and colloid co-loading in preventing spinal hypotension in parturients undergoing caesarean section

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Original Article

Author Details : Sushma KS, Jyoti B, Safiya I Shaikh

Volume : 3, Issue : 4, Year : 2016

Article Page : 621-625

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Abstract

Background: Spinal anaesthesia is the preferred technique for operative delivery in parturients, but associated hypotension can be detrimental for both mother and fetus. Different types (Crystalloid or colloid) and timings (preload or co-load) of fluids have been tried to decrease the incidence of hypotension. In our study, we planned to compare the efficacy of crystalloid co-loading and colloid co-loading in preventing hypotension in patients undergoing elective caesarean section under spinal anaesthesia.
Methods: 70 full term pregnant women with uncomplicated pregnancies scheduled for elective caesarean section under spinal anaesthesia were randomized to two groups to receive either crystalloid co-load or colloid co-load. Patients received either 15ml/kg of ringer’s lactate or 8ml/kg of 6% hydroxyl ethyl starch after cerebrospinal fluid was tapped during spinal anaesthesia. Blood pressure, heart rate, and oxygen saturation were measured every two minutes for first 20 minutes and every five minutes till the end of procedure. Vasopressor was administered if systolic pressure was less than 80% of baseline pressure. APGAR scores, nausea, and vomiting were also monitored.
Statistical analysis: Student’s t-test, chi-square test, fisher exact test.
Results: There was no statistically significant difference among the groups regarding systolic blood pressure and vasopressor requirements. The fall in diastolic blood pressure and mean arterial pressure was more in the crystalloid co-load group compared to the colloid co-load group. Neonatal outcomes and incidence of nausea and vomiting were comparable statistically among the two groups.
Conclusion: Colloid co-loading, even  though better than crystalloid co-loading in preventing hypotension in pregnant patients undergoing caesarean section under spinal anaesthesia, they are ineffective as a single measure as incidence of hypotension in both the groups >50%.

Keywords: Co loading, Crystalloids, Colloids, Hypotension, Spinal anaesthesia, Caesarean section

How to cite : Sushma Ks, Jyoti B, Shaikh S I, A randomized controlled trial to compare crystalloid and colloid co-loading in preventing spinal hypotension in parturients undergoing caesarean section. Indian J Clin Anaesth 2016;3(4):621-625

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