The Timing of Intravenous Crystalloid Administration and Incidence of Cardiovascular Side Effects During Spinal Anesthesia: The Results from a Randomized Controlled Trial

Mojica, José L.; Meléndez, Héctor Julio; Bautista, Leonelo E.

doi:10.1213/00000539-200202000-00039

Cited by 39 publications

(22 citation statements)

References 25 publications

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“…Our observation is similar to the previous studies. [6,7,11,16] In our study though there is no statistically significant difference, the incidence of hypotension is slightly more in patients who were preloaded compared to those who were co-loaded. The crystalloid fluid which was used for preloading 15 -20 mins before spinal anaesthesia has relatively short intravascular half-life.…”

Section: Discussionmentioning

confidence: 49%

“…Previous studies have used 15-20 mL/kg of RL for preloading in caesarean section. [7,15,16] In our study, we have preloaded our patients of Group P with 15 mL/kg of RL. In caesarean section of the patients with foetal distress where imminent delivery of the baby is warranted, preloading may waste valuable time.…”

Section: Discussionmentioning

confidence: 99%

“…SIH was defined as a decrease of > 30% in baseline systolic blood pressure or SBP < 90 mmHg. [7,10,11] CVSE were defined as SIH plus clinical symptoms (Nausea, vomiting or faintness) requiring treatment. [10] At the beginning of the procedure, patients were instructed to report any episode of nausea or faintness occurring during the intervention.…”

Section: Relative and Absolute Contraindication Of Spinalmentioning

confidence: 99%

“…[5] For last two decades the concept of co-loading (Infusion of fluid at the time of administering spinal anaesthesia) has come to vogue and several studies, both in pregnant and nonpregnant patients were done. [6,7] In our study, we have compared preloading with co-loading in emergency caesarean section for foetal distress. Aim of our study was to compare the incidence of hypotension intraoperatively and foetal outcome in two groups.…”

mentioning

confidence: 99%

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A Comparative Evaluation of Fluid Preloading vs. Co-Loading on Maternal Haemodynamics and Neonatal Outcome for the Parturients Undergoing Emergency Caesarean Delivery- A Prospective, Randomised, Double-Blind, Parallel Group Study

Halder¹,

Das²,

Mandal³

et al. 2018

jemds

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BACKGROUND Emergency caesarean section (CS) is very often done under spinal anaesthesia unless contraindicated. This neuraxial block results in hypotension caused by pharmacological sympathectomy. This effect can lead to cardiovascular side effects like hypotension, bradycardia, nausea, at the same time foetal jeopardy like foetal hypoxia and acidosis. These side effects can be prevented either by preloading with a crystalloid or simultaneous co-loading during intraoperative period. Here, in this prospective, double-blind study, we had compared the incidence of hypotension in intraoperative period and the foetal outcome in two groups. MATERIALS AND METHODS This prospective, randomised, double-blind, parallel group study was conducted in obstetric emergency OT of a tertiary care centre. 100 primigravida mothers aged between 18-29 years with ASA I physical status, posted for emergency CS due to foetal distress was randomly allocated for either preloading (Group P) or co-loading (Group C). RESULTS Fluid requirement was significantly less in co-loading group. There was no significant difference in the incidence of hypotension and ephedrine use. Foetal outcome in 1 min Apgar in Group C was significantly better, as the baby could be delivered quickly in Group C. CONCLUSION It is evident from our study that preloading can safely be avoided for spinal anaesthesia in CS posted for foetal distress. By using co-loading method, we can save valuable time required to deliver the baby and avoid circulatory overload without increasing incidence of hypotension.

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Section: Discussionmentioning

confidence: 49%

Section: Discussionmentioning

confidence: 99%

Section: Relative and Absolute Contraindication Of Spinalmentioning

confidence: 99%

mentioning

confidence: 99%

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A Comparative Evaluation of Fluid Preloading vs. Co-Loading on Maternal Haemodynamics and Neonatal Outcome for the Parturients Undergoing Emergency Caesarean Delivery- A Prospective, Randomised, Double-Blind, Parallel Group Study

Halder¹,

Das²,

Mandal³

et al. 2018

jemds

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“…Crystalloids and colloids are tried as pre loading fluids. Supporters who promote crystalloids (2,3,4,5) will highlight all the advantages such as easily availability, less reactions and cheap. Those who support colloids mention about the intravascular expansion capability, less volume required and long duration of action in-spite of high cost and fear of allergic reactions (6,7,8,9) .Following spinal anaesthesia, hypotension is a commonly seen because of autonomic blockade which is 2 segments higher than the sensory block (2,3) .…”

Section: Introductionmentioning

confidence: 99%

A Comparative Study Of Preloading Efficacy Of Ringer’s Lactate V/S 6% Heta Starch Solutions In Preventing Hypotensionfollowing Spinal Anaesthesia

Imran¹,

Padmanabha²,

Rehman³

et al. 2014

IOSRJDMS

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Hypotension during spinal anaesthesia is common and can cause significantmorbidity and mortality. Prior to spinal anaesthesia fluid administration isrecommended to reduce the incidence of hypotension and this is referred to aspreloading. Crystalloids and colloids are routinely tried as pre loading fluids but there is still considerable debate over their effectivenessas a pre loading. A comparative study was under taken to compare the hemodynamic changes of Ringers lactate v/s Hydroxy ethyl starch in 60 ASA grade-I &II patients posted for lower abdominal and lower limb elective surgeries and allocated into two groups. Each patient was administrated either Ringer's lactate solution at 10 ml/ Kg body or 6% Hydroxy ethyl starch at 10 ml/ Kg over a period of 20 minutes before spinal anaesthesia. Following spinal anaesthesia mean arterial pressure were recorded at regular intervals.We found that hydroxy ethyl starch is more effective than lactated Ringer's solution as a pre loading fluid in prevention of hypotension following spinal anesthesia. However, we also concluded that incidence of hypotension was only reduced but not completely eliminated in this study.

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Interventions for preventing hypotension in adults receiving spinal anaesthesia

Delgado¹,

Malagon²

2004

Cochrane Database of Systematic Reviews

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The Timing of Intravenous Crystalloid Administration and Incidence of Cardiovascular Side Effects During Spinal Anesthesia: The Results from a Randomized Controlled Trial

Cited by 39 publications

References 25 publications

A Comparative Evaluation of Fluid Preloading vs. Co-Loading on Maternal Haemodynamics and Neonatal Outcome for the Parturients Undergoing Emergency Caesarean Delivery- A Prospective, Randomised, Double-Blind, Parallel Group Study

A Comparative Evaluation of Fluid Preloading vs. Co-Loading on Maternal Haemodynamics and Neonatal Outcome for the Parturients Undergoing Emergency Caesarean Delivery- A Prospective, Randomised, Double-Blind, Parallel Group Study

A Comparative Study Of Preloading Efficacy Of Ringer’s Lactate V/S 6% Heta Starch Solutions In Preventing Hypotensionfollowing Spinal Anaesthesia

Interventions for preventing hypotension in adults receiving spinal anaesthesia

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