Comparison of different amounts of crystalloid preloading in elective cesarean sections under spinal anesthesia on maternal and neonatal effects

Comparison of different amounts of crystalloid preloading in elective cesarean sections under spinal anesthesia on maternal and neonatal effectsWe aimed to compare maternal and neonatal effects of 10, 15 or 20 mL/kg prophylactic preloading with RL infusion and constant ephedrine infusion (3 mg/min) started after spinal anaesthesia for avoiding hypotension due to spinal anesthesia in parturients scheduled to undergo elective cesareanSpinal anesthesia was performed following 10, 15 or 20 mL/kg RL iv preloading in 15 minutes in all parturients randomly allocated into three groups. As soon as parturients turned to supine position, 3 mg/min iv ephedrine infusion was administered until umbilical cord clamping in all groups. Heart rate (HR), mean arterial pressure (MAP) and peripheral oxygen saturation (SpO2) were monitored. Sensory and motor block levels were noted. Blood gas analysis was performed in the umbilical artery (UA) and vein (UV). Apgar scores, nausea-vomiting due to hypotension were evaluated. Constant ephedrine infusion with 20 mL/kg RL preloading resulted less decrease in MAP requiring less ephedrine with better Apgar scores in 1 min when compared to prophylactic 10 or 15 mL/kg RL preloading. Demographic properties, maximum sensory and motor block levels, UA blood gas analysis, SpO2 measures and operation times were similar among the groups. However, UV pCO2 decreased in the 20 mL/kg RL preloading group versus other groupsWe concluded that prophylactic infusion of 20 mL/kg RL prior to spinal anaesthesia followed by iv infusion of 3 mg/min of ephedrine after spinal anesthesia provided beter maternal hemodynamics without affecting neonatal parameters adversely in elective cesarean sections.Key Words: Cesarean section, spinal anesthesia, crystalloid infusion