Original article
Volume preload: lack of effect in the prevention of spinal-induced hypotension at caesarean section

https://doi.org/10.1016/S0959-289X(98)90001-2Get rights and content

Abstract

A randomized double-blind study of 40 women was performed to compare blood pressure changes between two groups of women following induction of spinal anaesthesia for elective caesarean section. One group received a 1 L Ringer's solution preload, administered over 10 min, before spinal anaesthesia while the other group received no preload. In both groups a prophylactic infusion of ephedrine (60 mg in Ringer's solution 1000 ml) was started immediately following intrathecal injection of local anaesthetic. There was no significant difference either in the ephedrine requirements or the incidence of hypotension between the two groups. There were no differences between the groups in terms of neonatal outcome as assessed by Apgar score, umblical arterial and venous blood pH, and Neonatal Adaptive Capacity Scores. When ephedrine is infused prophylactically immediately following spinal anaesthesia for elective caesarean section, a 1000 ml crystalloid preload confers no advantages in terms of maternal blood pressure control or neonatal outcome.

References (23)

  • S. Ramanathan et al.

    Vasopressor therapy for hypotension due to epidural anesthesia for cesarean section

    Acta Anesthesiol Scand

    (1988)
  • Cited by (52)

    • Comparison of phenylephrine infusion regimens for maintaining maternal blood pressure during spinal anaesthesia for Caesarean section

      2004, British Journal of Anaesthesia
      Citation Excerpt :

      Early papers suggested that vasopressors had detrimental effects on uteroplacental circulation and that their use should therefore be avoided until other measures of maintaining maternal BP had failed.14 The resulting reluctance to use vasopressors liberally has resulted in an emphasis on non-pharmacological methods for maintaining BP, such as i.v. fluid prehydration; however, recent data show that this has poor efficacy.6 7 The results of our present study argue further against this approach and suggest that it is safe to titrate phenylephrine, as required, to maintain maternal BP at values near normal.

    View all citing articles on Scopus
    View full text