Combined Colloid Preload and Crystalloid Coload Versus Crystalloid Coload During Spinal Anesthesia for Cesarean Delivery: A Randomized Controlled Trial

Tawfik, Mona K.; Tarbay, A.I.; Elaidy, Ahmed; Awad, Karim; Ezz, Hanaa Mohamed; Tolba, Mohamed Ahmed

doi:10.1213/ane.0000000000003306

Cited by 16 publications

(31 citation statements)

References 23 publications

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“…According to other authors, a greater pre-anaesthesia fluid administration is responsible for arterial hypotension rate drop [26 - 28]. A key element is that this filling was not carried out indiscriminately but was defined on the basis of two methods that potentially were able to identify patients who can benefit from this filling and to identify patients that do not need further fluid, avoiding any unsafe fluid overload.…”

Section: Discussionmentioning

confidence: 99%

Fluid administration guided by inferior vena cava ultrasound before spinal anaesthesia may reduce post procedural hypotension rate

Favre

Ceruti²,

Biggiogero

et al. 2021

Preprint

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PURPOSE: This study was conducted to estimate the incidence of hypotension after spinal anesthesia after inferior vena cava ultrasound (IVCUS) guided volaemic optimization compared with a control group in patients undergoing elective surgery. According to ESICM guidelines, hypotension was defined as two systolic arterial pressure (SAP) measurements < 80 mmHg and / or a mean arterial pressure (MAP) < 60 mmHg, or a drop in SAP of more than 50 mmHg or more than 25% from baseline, or a decrease in MAP by more than 30% from baseline and / or clinical signs/symptoms of inadequate perfusion. MATERIALS AND METHODS: From May 2014 to February 2019, a prospective, controlled, randomised, three-arm, parallel-group trial was performed in our tertiary hospital. In the IVCUS group (I, 132 patients) and passive leg raising test group (L, 148 patients), a pre-anaesthesia volume optimization was achieved following a fluid response protocol. In control group (C, 149 patients), no specific intervention was performed. RESULTS: 474 patients were collected. In group I, hypotension rate was 35%. In group L hypotension rate was 44%. In group C hypotension rate was 46%. An 11% reduction rate in hypotension (95% CI -1 to -24%, P=0.047) was observed between the group I and the group C. A 2% reduction rate in hypotension (95% CI -3 to -5%, P=0.428) was observed between group L and the group C. Total fluid amount administered was greater in the I group I than in the group C (593 ml versus 453 ml, P=0.015) and greater in the group L than the group C (511 ml versus 453 ml, P=0.11). CONCLUSION: IVCUS guided fluid optimization decrease the incidence of arterial hypotension after spinal anesthesia.

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Section: Discussionmentioning

confidence: 99%

Fluid administration guided by inferior vena cava ultrasound before spinal anaesthesia may reduce post procedural hypotension rate

Favre

Ceruti²,

Biggiogero

et al. 2021

Preprint

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“…These articles were published from 2001 to 2019 with sample sizes ranging from 36 to 205. All trials enrolled healthy parturients who were scheduled for elective surgery and applied SA for elective cesarean section: two trials [22,24] from India, two [23,25] from Egypt, one [17] from China, one [18] from Japan, one [19] from America, one [20] from Singapore, and one [21] from Lebanon.…”

Section: Study Selection and Characteristicsmentioning

confidence: 99%

“…As for the control groups, the infusion methods were set as 15 mL/kg colloid coload in two trials, [18,20] 10 mL/kg colloid coload in two trials, [22,24] 500 mL colloid coload in two trials, [19,21] and 1000 mL crystalloid coload in two trials. [23,25] Another trial did not specify the amount of crystalloid coload in the control group. [17] Eight trials [17][18][19][21][22][23][24][25] recorded the number of patients with hypotension throughout the surgery, among which three trials [21,23,25] were recorded as severe hypotension.…”

Section: Study Selection and Characteristicsmentioning

confidence: 99%

“…[23,25] Another trial did not specify the amount of crystalloid coload in the control group. [17] Eight trials [17][18][19][21][22][23][24][25] recorded the number of patients with hypotension throughout the surgery, among which three trials [21,23,25] were recorded as severe hypotension. As for the other hemodynamic variables, five trials [18][19][20][21][22] recorded the lowest intra-operative SBPs, and two [21,22] recorded the maximal intra-operative HRs.…”

Section: Study Selection and Characteristicsmentioning

confidence: 99%

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Effects of colloid preload on the incidence of hypotension in spinal anesthesia for cesarean section: a systematic review and meta-analysis

Gong

Liu

et al. 2021

Chinese Medical Journal

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Background:Hypotension is a common complication caused by spinal anesthesia (SA), which may have adverse impacts on the condition of the parturient and fetus. Liquid infusion was found to be relatively effective for reducing the incidence of hypotension. However, the question of whether colloid preload can optimize hemodynamic variables in the cesarean section remains controversial. This study aims to determine the effects of colloid preload on the incidence of hypotension induced by SA in elective cesarean section.Methods:Related keywords were searched on PubMed, EMBASE, and Cochrane Library from inception dates to May 2020. Studies included were evaluated for eligibility and quality. The primary outcome was the intra-operative incidence of hypotension and severe hypotension. The secondary outcomes included the lowest intra-operative systolic blood pressure, the maximal intra-operative heart rate, the intra-operative needs of ephedrine and phenylephrine, the incidence of maternal nausea and/or vomiting, and neonatal outcomes (umbilical artery pH and Apgar scores). Apart from the above, RevMan 5.3 was used for the data analysis.Results:Altogether nine randomized controlled trials were included in the meta-analysis. There were no significant differences in the incidence of intra-operative hypotension, severe hypotension, or neonatal outcomes between the colloid preload group and control group, except for the umbilical artery pH.Conclusion:This meta-analysis suggests that colloid preload does not significantly reduce the incidence of hypotension associated with SA in elective cesarean section.

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“…Olası hemodinamik komplikasyonları en aza indirmek için spinal anestezi uygulaması öncesinde kristaloid, kolloid gibi sıvılarla intravenöz (iv) sıvı yüklemesi (prehidrasyon) ve vazopressör kullanımı rutin anestezi uygulamalarından biridir(5,6).Near Infrared Spectroscopy (NIRS); bölgesel serebral oksijenasyonun (rSO2) ve perfüzyonun ölçülmesine olanak sağlayan, invazif olmayan, optik bir yöntemdir. Hipotansif cerrahilerde ve uzun süren operasyonlarda serebral doku oksijen düzeyini değerlendirmede fayda sağladığı gösterilmiştir (13).…”

unclassified

Spi̇nal Anestezi̇de Prehi̇drasyon Serebral Oksi̇jenasyonu Etki̇ler Mi̇?

Aydın

Gençay

et al. 2019

Kırıkkale Üniversitesi Tıp Fakültesi Dergisi

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Combined Colloid Preload and Crystalloid Coload Versus Crystalloid Coload During Spinal Anesthesia for Cesarean Delivery: A Randomized Controlled Trial

Cited by 16 publications

References 23 publications

Fluid administration guided by inferior vena cava ultrasound before spinal anaesthesia may reduce post procedural hypotension rate

Fluid administration guided by inferior vena cava ultrasound before spinal anaesthesia may reduce post procedural hypotension rate

Effects of colloid preload on the incidence of hypotension in spinal anesthesia for cesarean section: a systematic review and meta-analysis

Spi̇nal Anestezi̇de Prehi̇drasyon Serebral Oksi̇jenasyonu Etki̇ler Mi̇?

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