Effect of Glucose Containing Crystalloid Infusion on Maternal Hemodynamic Status After Spinal Anesthesia for Cesarean Section

Abstract

BackgroundDespite preventive strategies, hypotension is the most common complication of spinal anesthesia in cesarean section.ObjectivesThe aim of this study was to assess the effect of glucose-containing crystalloid infusion on maternal hemodynamic status after spinal anesthesia for cesarean section.MethodsIn this prospective, randomized, double-blind clinical trial, 80 parturients undergoing elective cesarean section with spinal anesthesia were studied. In group A (n = 40) ringer with 1% glucose solution (10 gr glucose in 1000 mL ringer) and in group B (n = 40) only ringer solution infused before and after spinal anesthesia. Demographic data, hemodynamic change, complications and their treatments, maternal blood sugar level and neonatal APGAR (appearance, pulse, grimace, activity and respiration) score, intraoperative fluid, duration of surgery, and anesthesia were recorded in the two groups.ResultsThe incidence of hypotension in group A was significantly lower than group B (27.5% vs 75%) (P = 0.002). Other complications (sustained hypotension, nausea, pallor, and shivering were significantly lower in parturients of the group A (P < 0.05). Maternal blood sugar (BS), before and after surgery, was not significantly different in the two groups (P = 0.207 and P = 0.239, respectively). There was no statistically significant difference in the APGAR score of neonates at the 1st and 5th minutes of the birth between the two groups (P = 0.076).ConclusionsIt seems that adding 1% glucose to crystalloid solution improves the hemodynamic status and decreases post-spinal anesthesia complications without significant changes in the maternal blood sugar level and APGAR score of neonates.

Effects of Hyperbaric and Isobaric Bupivacaine on Hemodynamic Profiles and Block Characteristics Among Parturients Undergoing Elective Cesarean Section Under Spinal Anesthesia: A Randomized Controlled Trial

“…They found a shorter duration of hypotension in the isobaric group compared to the hyperbaric bupivacaine group (1.67 ±7.8 min vs 7.4 ± 12.5 min, P = 0.004) and lower ephedrine requirements in the isobaric bupivacaine group than in the hyperbaric bupivacaine group (2.4 mg ± 6.6 mg vs 5.3 ± 10.7 mg, P = 0.006). 20 The results of our study are also inconsistent with those of a randomized controlled trial conducted at the Cantonal Hospital, which showed a greater reduction in MAP in the hyperbaric group than in the isobaric group. This difference might be due to the difference in the volume of bupivacaine used (10 mg), additive intrathecal fentanyl (15 µg), positioning, height of parturients, and differences in the study population.…”

“…This difference from our results might be due to the different doses of bupivacaine and the additives (15 µg fentanyl). 20 Another study by Helill et al revealed higher levels of sensory blockage in an isobaric bupivacaine group than in a hyperbaric bupivacaine group. A sensory block up to the T4 level was seen in three (6%) patients in the isobaric group and none in the hyperbaric group (P = 0.001).…”

“…The sample size was calculated based on previous studies conducted in Iran, which showed a significant reduction in mean systolic blood pressure with sustained duration for the isobaric vs hyperbaric groups. 20 We use N1= 42, µ1=7.8, SD1= 1.6 for isobaric bupivacaine group and N2= 42, µ2= 12.5, SD2=7.4 for the hyperbaric group. (Where N1=total population, µ1=mean, SD2= standard deviation in the isobaric group and N2=total population, µ2= mean, SD2=standard deviation in the hyperbaric group.…”

Magnesium Sulfate and Clonidine; Effects on Hemodynamic Factors and Depth of General Anesthesia in Cesarean Section

“…Gousheh et al (14) have stated the use of crystalloid solutions compared with colloid ones would stabilize blood pressure and heart rate after spinal anesthesia during cesarean section. This issue was more prominent when another author added glucose to the crystalloid solution (15). In contrast, another study has revealed that infusion of phenylephrine to prevent overt either hypotension or bradycardia was associated with better symptom (nausea and vomiting) control and also resulted in favorable neonatal blood gas outcomes (16).…”

Intrathecal Injection of Hyperbaric Bupivacaine Versus a Mixture of Hyperbaric and Isobaric Bupivacaine in Lower Abdominal Surgery: A Randomized Controlled Trial

“…It may be prepared as an isobaric or hyperbaric solution. Alterations in the baricity of spinal anesthetic solutions influence the distribution and hemodynamic parameters in the subarachnoid space ( 5 , 6 ). This may influence the onset, duration, and severity of sensory block and any side effects ( 4 , 6 ).…”