34. Prevention of hypotension in Patients Undergoing Elective Caesarean Section under Spinal Anesthesia: Effect of Preloading with Crystalloid versus Colloid Infusion
Zaid Jawaid1,Gul Bano Tariq1, Rizwan Ahmad1, Imran ul Haq1, Saba Saeed2 and
Sher Bahadur3
ABSTRACT
Objective: To compare effect of crystalloid and colloid in prevention of hypotension among patients undergoing elective C-section under spinal anesthesia.
Study Design: Comparative interventional study
Place and Duration of Study: This study was conducted at the Operation Theater of a tertiary care hospital, Peshawar during Aug to September 2019.
Materials and Methods: After taking the inform consents from patients (n=96) they were divided into two group using consecutive sampling technique. Before the spinal anesthesia group “A” (n=48) comprised of patient who received 1000ml crystalloid (Ringer Lactate) infusion, while group “B” (n=48) received 500 ml of colloid (haemaccel) infusion as pre-load. The outcomes were measure in term of mean arterial pressure (MAP) determined by formula MAP = Systolic BP+ 2(Diastolic PB)/3, where MAP ≥65 were considered normal. Both of the groups received 1000ml RL as routine during the operation. The data were recorded on structure Performa and analyzed using SPSS 20. Data were subjected to mean, SD, frequencies and percentages. For comparison of MAP student’s t-test and chi square test were used where p-value <0.05 was considered as significant.
Results: A total of 96 patients were included in the study out of them 48 had Crystalloid infusion and 48 Colloid solutions respectively. All these patients had normal mean arterial pressure before giving them spinal. Post spinal the incidence of hypotension was among 37(38.5%) of patients within 15 minutes. This decline in MAP was statistically significant (p=0.001) when it is compared between two groups; group ‘A’ with crystalloid and group ‘B’ with colloids. The incidence was 26 (55.2%) among patients with crystalloid infusion as compare to 11 (22.9%) among patients preloaded with colloid infusion.
Conclusion: Incidence of hypotension is common among patients with C-Section through spinal anesthesia. Colloid preloading could prevent hypotension efficiently as compared to crystalloid infusion. However the need of Phenylephrine was observed in both groups, where MAP was less than 65. It is recommended to give preference to colloid over crystalloid for preloading among patient undergoing through C-section under spinal anesthesia.
Key Words: Mean Arterial Pressure, Blood Pressure, C-Section, Crystalloid and Colloid solution
Citation of article: Jawaid Z, Tariq GB, Ahmad R, Haq I, Saeed S, Bahadur S. Prevention of hypotension in Patients Undergoing Elective Caesarean Section under Spinal Anesthesia: Effect of Preloading with Crystalloid versus Colloid Infusion. Med Forum 2019;30(11):128-131.