A randomized single-blinded comparative experimental study to test the influence of timing of intravenous fluid therapy on maternal hemodynamics during lower segmental caesarean section under spinal anaesthesia

Abstract

: Spinal anaesthesia-induced hypotension can be prevented by several techniques and methodologies, which is very important as the life of the mother and fetus is at risk. This study compared the efficacy of crystalloid administration 6 hours and half an hour before spinal anaesthesia on reducing hypotension.: After obtaining informed consent, 110 ASA 2 patients aged between 20 and 40 were scheduled for elective lower segmental caesarean section under spinal anaesthesia. Patients were randomly allocated into two groups. Group 1: Participants were kept nil per oral overnight, and Ringer's lactate was administered over half an hour before surgery. Group 2: participants were given ringer lactate. The amount was based upon the Holiday Segar formula (first 10 kg received 4ml/kg, 10-20 kg- 2ml/kg and remaining received 1 ml/kg) and given steadily over half an hour and 6 hours respectively in both groups. The incidence of hypotension and the need for rescue vasopressor in the two groups was recorded.: The two groups were statistically comparable in terms of age, height and weight. The incidence of Hypotension in Group 1 was 12.7%, and in Group 2 was 25%, which was statistically insignificant. Seven out of 55 patients in Group 1 had SBP<20% from baseline, whereas in Group 2, 14 patients out of 55 patients had SBP <20% from baseline, which was statistically insignificant. The incidence of ephedrine usage was statistically insignificant in both groups.: This study's results showed no statistically significant difference in preventing hypotension whether the fluids were given as 6 hours or half an hour before surgery. Therefore, to deliver preload of fluid, it is unnecessary to delay surgery.