Comparison between pre-loading and co-loading in spinal anaesthesia for Caesarean delivery at Kenyatta National Hospital

Abstract

Background: Hypotension after administration of spinal anaesthesia for caesarean delivery is a common adverse effect. Rapid fluid administration before the intrathecal injection of the local anaesthetic (pre-loading) has been found ineffective in prevention of hypotension. A co-load, given at the time of local anaesthetic administration, was found to be more effective Objectives: To compare the effect of timing of fluid administration either pre-loading or co-loading on changes of maternal hemodynamics and the amounts of vasopressors required to correct the hemodynamic changes. Methodology: In this randomized clinical study, 80 parturients undergoing elective caesarean section were randomized to the preload and coload groups. 500-1000mls bolus of crystalloid was given. Blood pressure and heart rate were recorded every 2.5 minutes. A vasopressor was administered when systolic blood pressure was <90mmHg or less than 80% of baseline blood pressure. Results: There was no significant difference in the two groups in the incidence of hypotension (p= 0.823), nausea and vomiting and vasopressor requirements. Conclusion: There is no difference in the incidence of hypotension whetlier patients were coloaded or preloaded.