Crystalloid Preload versus Coload in Prevention of Hypotension Following Spinal Anesthesia in Cesarean Section

Abstract

Ever since its introduction by in 1898, the popularity of SAB has seen periods of waxing and waning in anesthetist practice. With the introduction of safe local anesthetic drugs and consequent reduction in the incidence of neurological complications, SAB is still widely used in clinical practice. Due to its advantages such as a rapid onset of action, uniformly distributed analgesia, profound muscle relaxation, maintenance of clear mentation intraoperative, blunting of stress response, good postoperative recovery, SAB has replaced GA for lower abdominal and lower limb surgeries. SAB has proved to be extremely safe when managed well; however, there is still a risk of complications. Some of complications of SAB are hypotension, bradycardia, total spinal anesthesia and accidental intravascular injection. Hypotension is the most common complication occurring with spinal anesthesia which may be preventable or avoidable. Various techniques have been used to prevent SA induced hypotension. Some of these are preloading with IV fluids, low dose local anesthetics in SAB with or without additives and use of vasopressors prophylactically. Pre-loading with IV fluids has been considered safe and effective method. But, studies did not consistently prove the efficacy