INTRODUCTIONSpinal anaesthesia for caesarean section is the preferred option when balancing the risks and the benefits to the mother and foetus. With regional anaesthesia, the mother is able to share in the experience of the delivery, which may enhance mother-baby bonding. Hypotension after spinal anaesthesia for caesarean section remains a common and potentially serious complication. 1 Sympathetic block due to spinal anaesthesia along with aortocaval compression causes venous pooling leads to relative hypotension. This jeopardizes haemodynamic stability of mother and hampers blood flow to the placenta which may have detrimental effect on foetus.Techniques currently in use for preventing hypotension in elective caesarean section under spinal block include intravenous fluid pre-hydration, sympathomimetic drugs, ABSTRACT Background: Hypotension after spinal anaesthesia for caesarean section remains a common and potentially serious complication. Crystalloids are commonly used to counteract this adverse effect. Colloid solutions, such as albumin, hydroxylethyl starch (HES) and gelatin is effective alternatives. The main objective was to study to compare the effect of crystalloid and colloid preloading in elective caesarean section. Methods: It was a randomized controlled study conducted at North Bengal Medical College under Department of Anesthesiology in collaboration with Department of Gynaecology and Obstetrics from July 2011 to June 2012. Eighty patients were randomly allocated to two equal groups of 40 each in group 1 (Patients with Ringer's lactate) and group 2 (Patients with hydroxylethyl starch) before performing spinal anaesthesia. Results: In the present study, the incidence of hypotension was more in Ringer's lactate group than hydroxylethyl starch group. The fall of systolic blood pressure, mean blood pressure were higher in Ringer's lactate group (group 1) than 6% hydroxylethyl starch group (group 2). The changes in heart rate, SpO2 and respiratory rate were clinically insignificant in both groups. Also, the time intervals from induction to reach block height upto T5, incision-delivery were similar for group 1 and group 2. Also, there was no clinical difference in neonatal outcome as measured by Apgar scores at 1 minute and 5 minutes between group 1 and group 2. Conclusions: The preloading with 6% hydroxyethyl starch in elective caesarean section was able to prevent the maternal hypotension better than preloading with Ringer's lactate solution without any significant neonatal adverse effect.

BACKGROUND