Abstract :
Background & Objective: Crystalloid preloading has been found ineffective in preventing maternal hypotension following spinal anaesthesia for lower segment cesarean section (LSCS), while coloading has shown variable results. One crucial but underexplored factor is the speed of crystalloid coloading, particularly during the peak sympathetic block-induced vasodilatation (5–7 minutes post-spinal anaesthesia). This double-blind randomized controlled trial (RCT) aimed to investigate the effect of different crystalloid coloading infusion speeds and volumes on maternal hemodynamics during elective LSCS to enhance perioperative stability and recovery.
Material and Methods: A double-blind, randomized, single-center, parallel-group comparative trial was conducted on 68 patients undergoing elective LSCS. Patients were randomly allocated into two groups to assess the impact of crystalloid coloading speed on maternal hemodynamics. Group A received Ringer Lactate (RL) coloading through an 18G intravenous cannula at an infusion rate of ninety millilitres per minute, while Group B received RL coloading through a 16G intravenous cannula at an infusion rate of one hundred eighty millilitres per minute. Both groups received RL at 20 mL/kg following spinal anaesthesia. Mephentermine was administered to maintain mean arterial pressure (MAP) within ?20% of baseline.
Results: A significant drop in MAP (?20% below baseline) was observed in 88.24% of patients in Group A and 82.35% in Group B (P
Conclusion: Crystalloid coloading alone not effectively prevent maternal hypotension following spinal anaesthesia, likely due to an inability to achieve the optimal infusion speed and volume within 5–7 minutes of peak sympathetic blockade. Venous cannula size and vein selection may significantly impact fluid administration efficiency, necessitating further research.
Keyword :
Crystalloid, Coloading, Preloading, Spinal anaesthesia, LSCS.