Frequency of hypotension induced by spinal block in patients preloaded with crystalloid solution in elective caesarian section

Paper Details

Research Paper 01/01/2020
Views (266) Download (11)

Frequency of hypotension induced by spinal block in patients preloaded with crystalloid solution in elective caesarian section

Muhammad Tayyeb, Shah Faisal, Irfan Ullah, Muhammad Ajmal, Mukhtair Ahmad, Ayub Said
Int. J. Biosci.16( 1), 465-469, January 2020.
Certificate: IJB 2020 [Generate Certificate]


The aim of the study is to find hypotension induced by spinal anesthesia preloaded with crystalloid solution in elective Cesarean patients. A Descriptive cross-sectional study carried out in Lady reading hospital (LRH) from March to June of 2018 after acceptance of approval from committee of institute of paramedical science (IPMS) Khyber Medical University Peshawar and by Head of the Department of Anesthesia, Lady reading hospital (LRH). A total 246 participants presenting for elective Cesarean section under spinal anesthesia preloaded with crystalloid solution with different ages of total 200 hypotensive, Hypotension occurred after 2 minutes (N=58, 29%), 5 minutes (N=64, 32%), 7 minutes (N=49, 24.5%) and 10 minutes (N=29, 14.5%).240 (81.3%) patients are found hypotensive whereas other patients (18.7%) remain stable. To prevent Spinal Anesthesia induced hypotension in Caesarean Section, preloading of crystalloid solutions is not of much benefit.


Bajwa SJS, Kulshrestha A, Jindal R. 2013. Co-loading or pre-loading for prevention of hypotension after spinal anaesthesia a therapeutic dilemma. Anesthesia, Essays and Researches 7(2), 155.

Bassell GM, Marx GF. 1994. Intravenous fluid preload in the prevention of spinal block-induced hypotension in parturients. Anesthesiology 80(3), 702.

Bottiger BA, Bezinover DS, Mets B, Dalal PG, Prozesky J, Ural S, Vaida S. 2016. Phenylephrine infusion for spinal-induced hypotension in elective cesarean delivery: Does preload make a difference?.Journal of anaesthesiology, Clinical Pharmacology 32(3), 319.

Chumpathong S, Chinachoti T, Visalyaputra S, Himmunngan T. 2006. Incidence and risk factors of hypotension during spinal anesthesia for cesarean section at Siriraj Hospital. J Med Assoc Thai 89(8), 1127-32.

Fakherpour A, Ghaem H, Fattahi Z, Zaree S. 2018. Maternal and anaesthesia-related risk factors and incidence of spinal anaesthesia-induced hypotension in elective caesarean section: A multinomial logistic regression. Indian Journal of Anaesthesia 62(1), 36.

Farid Z, Mushtaq R, Ashraf S, Zaeem K. 2016. Comparative efficacy of crystalloid preloading and co-loading to prevent spinal anesthesia induced hypotension in elective caesarean section. Pak J Med Health Sci 10(1), 42-5.

Hasanin A, Mokhtar AM, Badawy AA, Fouad R. 2017. Post-spinal anesthesia hypotension during cesarean delivery, a review article. Egyptian Journal of Anaesthesia 33(2), 189-193.

Hofhuizen C, Lemson J, Snoeck M, Scheffer GJ. 2019. Spinal anesthesia-induced hypotension is caused by a decrease in stroke volume in elderly patients. Local and regional anesthesia 12, 19.

Joshi MC, Raghu K, Rajaram G, Nikhil N, Kumar S, Singh A. 2018. Baseline heart rate as a predictor of post-spinal hypotension in patients undergoing a caesarean section: An observational study. Journal of Obstetric Anaesthesia and Critical Care 8(1), 20.

Kenny LC, Myers JE. 2017. Obstetrics by ten teachers. CRC Press.

Montoya Botero BH, Oliveros Wilches CI, Moreno Martínez DA. 2009. Managing hypotension induced by spinal anesthesia for caesarean section. RevistaColombiana de Anestesiología 37(2), 131-140.

Ni HF, Liu HY, Zhang J, Peng K, Ji FH. 2017. Crystalloid Coload reduced the incidence of hypotension in spinal anesthesia for cesarean delivery, when compared to crystalloid preload: a meta-analysis. BioMed research international, 2017.

Oh AY, Hwang JW, Song IA, Kim MH, Ryu JH, Park HP, Do SH. 2014. Influence of the timing of administration of crystalloid on maternal hypotension during spinal anesthesia for cesarean delivery: preload versus coload. BMC anesthesiology 14(1), 36.

Rocke DA, Rout CC. 1995. Volume preloading, spinal hypotension and caesarean section. British Journal of Anaesthesia 75(3), 257-259.

Rout CC, Rocke DA, Levin J, Gouws E, Reddy D. 1993. A reevaluation of the role of crystalloid preload in the prevention of hypotension associated with spinal anesthesia for elective cesarean section. Anesthesiology 79(2), 262-269.

Rout CC, Rocke DA. 1994. Prevention of hypotension following spinal anesthesia for cesarean section. International Anesthesiology Clinics 32(2), 117-136.

Serpell MG, Fettes PD, Wildsmith JA. 2002. Pencil point spinal needles and neurological damage. Br J Anaesth. Nov 1;89(5), 800-1.

Tatikonda CM, Rajappa GC, Rath P, Abbas M, Madhapura VS, Gopal NV. 2019. Effect of intravenous ondansetron on spinal anesthesia-induced hypotension and bradycardia: A randomized controlled double-blinded study. Anesthesia, Essays and Researches 13(2), 340.