Comparison of Crystalloid Preloading with Co-Loading on Maternal Hemodynamics in Elective Lower Segment Caesarean Section under Spinal Anaesthesia

Spinal anaesthesia is the most common technique used for lower segment caesarean sections(LSCS). but it has own disadvantages too. Maternal haemodynamic changes is more profound in pregnant population. Aim of the study was to compare the maternal haemodynamic changes with crystalloid preloading and co-loading in patients undergoing elective lower segment caesarean section under spinal anaesthesia.

80 obstetric patients with period of gestation (POG) more than 37 weeks, in the age between 18 to 35 years, belonging to ASA class I and II and scheduled for elective LSCS were randomized into two groups. Group P - Patient receiving preloading with Ringer Lactate at a dose of 15ml/kg. Group C – Patient receiving Co-loading with Ringer Lactate at a dose of 15ml/kg. Primary objectives of the study were haemodynamic changes like Heart rate (HR), Systolic blood pressure (SBP), diastolic blood pressure (DBP) and mean arterial pressure (MAP) and these parameters were recorded baseline, at 1 min interval for first 10 minutes, after that at 5 minutes till 20 minutes and then every 15 min till completion of procedure.

The demographic data were comparable in group P and group C. The mean (SD) HR was significantly higher in group P as compared to group C at 5,6,7,8 and 9 minutes (p <0.05). The mean (SD) SBP, DBP and MBP was significantly lower in group P as compared to group C at 5,6 and 7 minutes (p <0.05). Significant difference was seen in the distribution of nausea/vomiting score between group P and C. (p value<.05).

We conclude that co-loading with crystalloids is provide more Maternal Hemodynamics stability after subarachnoid block rather than preloading with crystalloids.