COMPARISON OF PRE-LOADING AND CO-LOADING WITH CRYSTALLOID IN SPINAL ANAESTHESIA UNDERGOING TOTAL ABDOMINAL HYSTERECTOMY

Abstract

Introduction:
Abdominal hysterectomy is a common procedure done in hospitals. Spinal anaesthesia remains the preferred choice for abdominal hysterectomy across the world with a low failure rate. However spinal anaesthesia-induced hypotension is the commonest complication. Using fluid and vasopressors to manage hypotension following spinal anaesthesia is a common clinical issue. Co-loading presents a challenge to the traditional pre-loading instructional methods of today. Determining the optimal time for fluid delivery was the aim of this study.
Materials and Procedures:
In this Retrospective, observational study, 75 spinal anaesthesia patients who underwent
complete abdominal hysterectomy were considered. Patients were randomized to receive
intravenously 20 ml/kg of crystalloid over a 20-minute period, either prior to spinal anaesthesia
(Group-1) or right after (Group-2).
We evaluated the incidence of hypotension with the amount of vasopressor used. Statistically
analyse the results with student T-test, chi-square and P value less than 0.05 declared as statistically significant.
Results:
The incidence of hypotension (Group 1: 65.6%, Group 2: 12.8%) and the total amount of
vasopressor doses needed were significantly different across the groups.
Conclusion:
In summary, there's no need to postpone surgery in order to administer a crystalloid preload.
After spinal anaesthesia, crystalloid co-loading is superior to preloading in terms of blood
pressure maintenance.