Combined Colloid Preload And Crystalloid Coload Versus Crystalloid Coload During Spinal Anesthesia for Cesarean Delivery

Combined Colloid Preload And Crystalloid Coload Versus Crystalloid Coload During Spinal Anesthesia for Cesarean Delivery

The study will compare one technique of fluid administration (combined colloid preload and crystalloid colaod) with another one (crystalloid coload) during elective cesarean delivery performed under spinal anesthesia.

This randomized, controlled, double-blind study will be conducted on ASA physical status II parturients with full-term singleton pregnancy undergoing elective cesarean delivery under spinal anesthesia. Participants will receive either 500 mL colloid preload and 500 mL crystalloid coload (Combination group) or 1000 mL crystalloid coload (Coload group). Systolic blood pressure will be recorded every minute and ephedrine will be administered when hypotension occurs according to a predefined protocol. The total ephedrine dose, time to the first ephedrine dose, heart rate, inferior vena cava diameter, nausea/vomiting, and neonatal Apgar scores will be recorded.

Inclusion Criteria:

• American Society of Anesthesiologists physical status II parturients
• Full term, singleton pregnancy
• Elective cesarean delivery under spinal anesthesia

Exclusion Criteria:

• Age <19 or > 40 years
• Height <150 cm
• Weight <60 kg
• Body mass index ≥40 kg/m2
• Contraindications to spinal anesthesia (increased intracranial pressure, coagulopathy, or local skin infection)
• Chronic or pregnancy-induced hypertension
• Hemoglobin <10 gm/dL.
• Diabetes mellitus, cardiovascular, cerebrovascular, or renal disease
• Polyhydramnios or known fetal abnormalities