Colloid coload versus crystalloid coload to prevent maternal hypotension in women receiving prophylactic phenylephrine infusion during caesarean delivery: a randomised controlled trial

Park, Sun-Kyung; Park, Dong-Nyeok; Kim, Young‐Won; Yoo, Seung Hoon; Lim, Young-Jin; Park, Joong Shin; Jun, Jong Kwan; Kim, Jin‐Tae

doi:10.1016/j.ijoa.2021.103246

Cited by 5 publications

(2 citation statements)

References 30 publications

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“…Many authors found that the colloid coload was superior to the crystalloid coload in reducing the incidence of SAIH, nausea and vomiting in combination with prophylactic phenylephrine infusion, but no statistical difference was found between the two groups, [23][24][25] which was consistent with our findings. Different from previous research methods, the strength of our study was that prospectively compared quantifiable effect of crystalloid coload versus colloid coload on norepinephrine requirement for preventing SAIH for cesarean delivery, and derived ED 50 and ED 90 values of norepinephrine infusion dose by probit regression, so as to provide guidance for the appropriate initial infusion dose of norepinephrine combined with crystalloid coload or colloid coload.…”

supporting

confidence: 89%

Comparative Dose–Response Study on the Infusion of Norepinephrine Combined with Crystalloid Coload versus Colloid Coload for Preventing Hypotension During Spinal Anesthesia for Cesarean Delivery

Jin¹,

Mao²,

Liu³

et al. 2022

DDDT

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Background Although the optimal infusion dose of norepinephrine combined with crystalloid coload for preventing spinal anesthesia-induced hypotension (SAIH) for cesarean delivery has been established, the infusion regimen of norepinephrine combined with colloid coload has not been fully quantified. The objective of this study was to compare and determine the median effective dose (ED 50 ) and 90% effective dose (ED 90 ) of norepinephrine infusion combined with crystalloid coload versus colloid coload for preventing SAIH during cesarean delivery. Methods Two hundred parturients were randomly assigned to receive norepinephrine infusion at 0.02, 0.04, 0.06, 0.08, or 0.10 µg/kg/min in combination with 10 mL/kg crystalloid coload or colloid coload to prevent SAIH. The study period was defined as the interval from the commencement of intrathecal injection to delivery of the neonate. The primary outcome was non-occurrence of hypotension, defined as systolic blood pressure (SBP) less than 80% of the baseline before delivery. The ED 50 and ED 90 of norepinephrine infusion dose were determined using probit regression analysis. By calculating the 95% confidence intervals (CIs) of relative median potency to determine whether the prophylactic infusion of norepinephrine requirement was different between the two groups. Results The derived ED 50 and ED 90 of norepinephrine infusion combined with crystalloid coload were 0.030 (95% CIs 0.020 to 0.038) and 0.097 (95% CIs 0.072 to 0.157) µg/kg/min, respectively. The ED 50 and ED 90 of norepinephrine infusion combined with colloid coload were 0.021 (95% CIs 0.013 to 0.029) and 0.070 (95% CIs 0.053 to 0.107) µg/kg/min, respectively. The estimate of relative median potency for norepinephrine between the two groups was 1.37 (95% CIs 0.94 to 2.23). Conclusion Under the conditions of this study, 10 mL/kg colloid coload reduced the dose of prophylactic norepinephrine infusion by approximately 30% in parturients during spinal anesthesia for cesarean delivery compared with the crystalloid coload.

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supporting

confidence: 89%

Comparative Dose–Response Study on the Infusion of Norepinephrine Combined with Crystalloid Coload versus Colloid Coload for Preventing Hypotension During Spinal Anesthesia for Cesarean Delivery

Jin¹,

Mao²,

Liu³

et al. 2022

DDDT

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“…However, this difference was not significant. In the literature, the incidence of hypotension ranges from 13% to 90% (5,6,12,(23)(24)(25). Most studies have compared the incidence of hypotension between preloading with colloids and crystalloids.…”

Section: Discussionmentioning

confidence: 99%

The Effect of Adding 1% Glucose to Crystalloid on Maternal Hemodynamics After Spinal Anesthesia for Cesarean Delivery: A Double-Blind, Randomized Clinical Trial

Saghravanian,

Tabari,

Afzalaghaee

et al. 2023

Middle East J Rehabil Health Stud

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Background: We aimed to evaluate the effect of glucose-containing crystalloid infusion before anesthesia induction on hemodynamics and postanesthesia complications. Methods: This double-blind, randomized clinical trial was conducted on 60 parturient cases scheduled for elective Cesarean delivery under spinal anesthesia who were referred to the teaching hospitals of Mashhad University of Medical Sciences (Iran). The parturients were randomized into two groups. Both groups received 5 - 7 mL/kg of intravenous bolus serum before spinal anesthesia. The parturients in the glucose-containing normal saline (GcNS) group received 1% glucose solution in normal saline. The normal saline (NS) group received only normal saline. Systolic blood pressure (SBP), diastolic blood pressure (DBP), heart rate (HR), blood glucose concentrations, neonatal Apgar scores, postanesthesia complications, and ephedrine and atropine consumption were evaluated. Results: Sixty patients were recruited (30 in each group), with a mean age of 29.14 ± 6.01 and 29.76 ± 6.15 years in the GcNS and NS groups, respectively. There was no significant difference between the two groups in SBP, DBP, or HR after baseline adjustment. The incidence of hypotension was higher in the NS (70.0%) compared to the GcNS group (46.6%), but the difference was not significant. There was no significant difference in Apgar scores. The incidence of nausea, vomiting, pallor, and shivering was higher in the NS group. However, only nausea and vomiting 10 minutes after anesthesia induction were significant. Ephedrine and atropine consumption was higher in the NS group, but not significantly. Conclusions: The present study did not show any clear benefit for adding 1% glucose to normal saline solution preload for hypotension in parturients undergoing Cesarean delivery with spinal anesthesia.

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Neuraxial anaesthesia-induced hypotension during Caesarean section

Bhat,

Singh,

Palanisamy

2024

BJA Education

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Colloid coload versus crystalloid coload to prevent maternal hypotension in women receiving prophylactic phenylephrine infusion during caesarean delivery: a randomised controlled trial

Cited by 5 publications

References 30 publications

Comparative Dose–Response Study on the Infusion of Norepinephrine Combined with Crystalloid Coload versus Colloid Coload for Preventing Hypotension During Spinal Anesthesia for Cesarean Delivery

Comparative Dose–Response Study on the Infusion of Norepinephrine Combined with Crystalloid Coload versus Colloid Coload for Preventing Hypotension During Spinal Anesthesia for Cesarean Delivery

The Effect of Adding 1% Glucose to Crystalloid on Maternal Hemodynamics After Spinal Anesthesia for Cesarean Delivery: A Double-Blind, Randomized Clinical Trial

Neuraxial anaesthesia-induced hypotension during Caesarean section

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