Though spinal block has several advantages like sensory block, muscle relaxation, awake patient, the most common and serious problem with spinal anaesthesia for caesarian section remains rapid profound hypotension due to sympathetic blockade. Preloading is an established method to prevent hypotension due to spinal anaesthesia. AIM: This study is an attempt to compare the usefulness of hetastarch (colloid) with ringer lactate solution (crystalloid) for volume preloading in the prevention of spinal hypotension in caesarian sections. MATERIALS AND METHODS: Informed consent was taken from a total of 120 parturients of ASA grade I, IE without maternal or fetal complications scheduled for elective or emergency for primary or repeat caesarian section at term, for this study in King George Hospital, Visakhapatnam. The study subjects were allocated into 3 groups of 40 each. Group A (40 parturients)-without preloading, Group B (40 parturients)-Crystalloid group-received preload infusion of Ringer lactate solution, 1000 ml, Group C (40 parturients)-Colloid group-received preload infusion of 6% Hydroxy Ethyl starch, 500 ml. CONCLUSION: From this study we conclude that 6% hydroxyethyl starch is better choice for prevention of hypotension following spinal anaesthesia in caesarian section in comparison to lactated ringer solution.

Vecuronium, a commonly used neuromuscular blocking agent during general anaesthesia, induced bronchospasm in a pregnant patient posted for emergency caesarean section. Two episodes of bronchospasm shortly following administration of vecuronium. Vecuronium was the suspected culprit. Allergic skin tests proved that the bronchospasm is a manifestation of anaphylaxis induced by vecuronium.