A Comparative Study Of Effect Of Rapid Crystalloid Preload And Intravenous Ephedrine In Management Of Hypotension Due To Subarachanoid Block In Elective Caesarean Section

Abstract

Background and objectives: Spinal anaesthesia is a preferred technique for caesarean delivery for its distinct advantages over general anaesthesia such as avoidance of airway related complications, aspiration, neonatal depression with anaesthetic agents. However hypotension is commonly associated with spinal anaesthesia, which has detrimental effect on both mother and fetus. Thus in this study the role of pre-treatment with crystalloid preloading and prophylactic I.V. Ephedrine in preventing spinal hypotension in caesarean patients is being evaluated. Methods: The study was conducted on 60 healthy pregnant mothers without foetal compromise undergoing elective caesarean section under spinal anaesthesia. Patients were randomly divided into two groups. Group P (n=30) patients were preloaded with Ringer Lactate solution at 10ml/kg over 15-20 min prior to spinal anaesthesia. Group E (n=30) patients were given Inj. Ephedrine 10mg I.V. bolus immediately after spinal anaesthesia. Results: The incidence of hypotension was higher in Group P as compared to Group E (p value<0.05). Neonatal outcome were similar in both the groups. Conclusion: Prophylactic intravenous bolus dose of Injection Ephedrine 10mg is safe, quick and more effective than crystalloid preloading for maintenance of maternal blood pressure close to the baseline level in a healthy parturient undergoing caesarean section under spinal anaesthesia.