Comparison of colloid versus crystalloid preload for prevention of hypotension during spinal anesthesia for elective cesarean section in women with positive supine stress … est

Abstract EN

Background / Aim : if parturient prone to develop cavil compression n the supine position were identified before delivery; this might a method of predicting hypotension during cesarean section under spinal anesthesia.

Colloid preloading is thought to be superior to crystalloid n reducing the risk for spinal anesthetic induced hypotension.

It is postulated that parturient preoperatively susceptible to the supine position would benefit the most from colloid preloading.

The aim of this study is to compare colloid versus crystalloid preload for prevention of hypotension during spinal anesthesia for elective cesarean section in women with positive supine stress test (SST).

Patients & Methods : Forty healthy women, with term singe ton normal pregnancies presenting for elective cesarean section under spinal anesthesia were included n the study.

All patients were positive for supine stress test (SST), they were divided into 2 equal groups (20 patients each), crystalloid preload group (group I) and colloid preload group (group II).

Maternal hypotension, nausea, vomiting or dizziness and ephedrine requirements were recorded during the study.

Induction-to-uterotomy interval, uterotomy-to- delivery interval and intraoperative blood loss, were also recorded.

Moreover, Apgar score and musical artery acid-base status at delivery were measured.

Results : our results showed that n patients received crystalloid preload (group I) the frequencies of occurrence of decreased systolic blood pressure elbow 100 mmHg or 20 % from baseline, occurrence of vomiting, nausea or dizziness were 14(70 %), 7(35 %), 9(45 %), and 7(35 %), respectively, while, in patients received colloid preload (group E) were 6(30 %), 1(5 %), 2(10 %), and 1(5 %), respectively.

So, patients received crystalloid preload showed a higher frequency of hypotension, vomiting, nausea and dizziness compared to colloid group (P < 0.05), and also a greater need for ephedrine, mean(+SD) was 21 (±11.4) n group I compared to 7.2(±5.3)mg in group II(P < 0.05).

Conclusions : pregnant women with a positive preoperative supine stress test constitute a subset at increased risk for clinically significant hypotension during cesarean delivery under spinal anesthesia.

These women seem more likely to benefit from prophylactic colloid solution preload.