Comparative study of preloading and Co-loading with ringer lactate for prevention of spinal hypotension in elective cesarean section

Background: Prevention of spinal induced hypotension was remained challenge to anaesthesiologist for years as it poses risk to mother as well as baby. Prehydration with various volumes of crystalloid or colloids was attempted in the past variable success rate. Recently the principle of preloading with fluids has been challenged by various studies. This prompted us to evaluate the effectiveness of crystalloid preloading compared to preloading for prevention of spinal hypotension. We evaluated vasopressor requirement and neonatal Outcome in the form of APGAR score as well. Material and method: ASA grade I parturients posted for elective cesarean section were randomly allocated in two study groups of 30 each to receive either preload or co-load with Ringers lactate solution. Blood pressure, heart rate, SpO2, vasopressor requirement and other outcomes recorded at regular interval. Results: Hypotension was observed significantly less in co-loading group (36%) than preloading group (60%). Mean vasopressor requirement was also significantly more in preload group. Heart rate change, nausea, vomiting and fetal outcome remained same across both the groups. Conclusion: Co-loading with crystalloids is more effective strategy than preloading in prevention of spinal induced hypotension. We can save valuable time given for preloading in case of emergency cesarean sections.