Spinal Anaesthesia Induced Hypotension and Related Adverse Effects in Caesarean Section Delivery and Neonatal Outcome: A Comparison of Using Crystalloid Pre-Loading and Co- Loading in Caesarean Patients
DOI:
https://doi.org/10.31344/ijhhs.v5i1.240Keywords:
Crystalloid pre-loading, crystalloid co-loading, spinal anaesthesia, hypotension, neonatal outcome, APGAR scoreAbstract
Background: Volume loading by rapid infusion of crystalloid solution before/during induction of spinal anaesthesia may effectively reduce the incidence of anaesthesia induced hypotension.
Objective:To compare the efficacy of crystalloid pre-loading and co-loading to preventhypotension and related adverse effects as well aspoor neonatal outcome in caesarean section delivery under spinal anaesthesia.
Methods:This single blinded randomized controlled clinical trial was conducted in the Department of Anaesthesia, Analgesia & Intensive Care, Dhaka Medical College Hospital, Dhaka, between January 2013 and December 2014. A total of 90 patients were selected –45patients of group I received co-loading with Ringer’s lactatesolution, while another 45 patients of group II received a pre-loading of the same fluid.Blood pressure and heart rate were recorded. Ephedrine and adrenaline were administered as needed to treat hypotension.APGAR scores of the newborn were recorded at 1st minute and 5th minute after delivery. Adverse effects like nausea, vomiting, light headedness and shivering was observed all through during operation and post-operative phase in all patients, if any, and recorded.
Results:The incidence of hypotension was 17 (37.8%) in group I (co-loading) and 27 (60%) in group II (pre-loading), which was significantly higher in group II (p<0.05).Adverse effects – nausea, vomiting, light headedness and shivering was observed more in group II patients; however, the difference was not statistically significant. In neonates, APGAR score at 1 minute was found ≤7 in 18 (40.0%) from group I, while 28 (62.2%) from group II; the difference was statistically significant (p<0.05). No significant difference was observed in APGAR score at 5 minutes, as found ≤7 in 6 (13.3%) and 3 (6.7%) in group I andgroup II respectively.
Conclusion:Severity of hypotension, increased ephedrine requirement and poor APGAR score wereevident in patients who received crystalloid pre-loading group(group II), which meanscrystalloid co-loading group(group I) procedurewas more effective in preventing spinal anaesthesia induced hypotension and secured better neonatal outcome.
International Journal of Human and Health Sciences Vol. 05 No. 01 January’21 Page: 90-95
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2020 Taneem Mohammad, Moinul Hossain Chowdhury, Shamima Akter, Mohammad Abdul Karim Miah, - Mohammad Mohsin, SM Ahsanul Habib, Arifa Sultana
This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors who publish in the International Journal of Human and Health Sciences agree to the following terms that:
- Authors retain copyright and grant International Journal of Human and Health Sciences the right of first publication of the work.
Articles in International Journal of Human and Health Sciences are licensed under a Creative Commons Attribution 4.0 International License CC BY-4.0.This license permits use, distribution and reproduction in any medium, provided the original work is properly cited.- Authors are able to enter into separate, additional contractual arrangements for the distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
- Authors are permitted to post their work online (e.g., in institutional repositories or on their website) as it can lead to productive exchanges, as well as greater citation of published work.
