The Effect of the Timing of Colloid and Crystalloid Infusions on Postspinal Hypotension After Spinal Anesthesia for Caesarian Section

Prevention of Postspinal Hypotension After Spinal Anesthesia for Caesarian Section, the Comparison of Crystalloid and Colloid Infusions and Their Timing Via Perfusion Index and Plethysmographic Variability Index

Prevention of postspinal hypotension after spinal anesthesia for caesarian section by use of preoperative or intraoperative volume replacement. The comparison of crystalloid and colloid infusions and their timing via perfusion index and plethysmographic variability index.

To Prevent hypotension fluid replacement is usually used in pregnant patients scheduled for C/S. Different types of fluids can be used in order to achieve this. Also the timing of fluid replacement is important. In the present study patients were separated into 4 groups. Each receiving a one of two fluids in different times. ( Colloid pre-load, colloid co-load, crystalloid co-load and crystalloid pre-load.) The effect of overall hemodynamics and the incidence of hypotension are evaluated. Also peripheric monitors like perfusion index and plethysmographic variability index are evaluated for correlation.

Inclusion Criteria:

• pregnant 37-41 weeks
• one fetus
• scheduled for C/S under spinal anesthesia
• accepting to participate

Exclusion Criteria:

• Emergency surgery
• placenta previa
• preeclampsia
• cardiovascular and cerebrovascular comorbidities
• morbid obesity (BMI>40)
• pregnancy weeks <36 and > 41
• The use of vasoconstrictors
• Severe Anemia ( Hb <9 g/dl)
• Refusal or known contraindication for spinal anesthesia