Comparison between colloid preload and crystalloid co-load in cesarean section under spinal anesthesia: a randomized controlled trial

Tawfik, Mona K.; Hayes, Salwa M.S.; Jacoub, F.Y.; Badran, B.A.; Gohar, Faekah; Shabana, Amir M.; Abdelkhalek, Mostafa; Emara, Mahmoud

doi:10.1016/j.ijoa.2014.06.006

Cited by 44 publications

(43 citation statements)

References 33 publications

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“…We included 109 out of 1021 retrieved trials, which included 8561 women (Fig. and see also Supporting Information, Table S1) . Twelve interventions (eleven active treatments and one inactive control) to prevent intra‐operative hypotension were studied, with 30 direct comparisons (see also Supporting Information, Table S2).…”

Section: Resultsmentioning

confidence: 99%

Prevention of hypotension after spinal anaesthesia for caesarean section: a systematic review and network meta‐analysis of randomised controlled trials

et al. 2019

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Summary Spinal anaesthesia for caesarean section commonly causes maternal hypotension. This systematic review and network meta‐analysis compared methods to prevent hypotension in women receiving spinal anaesthesia for caesarean section. We selected randomised controlled trials that compared an intervention to prevent hypotension with another intervention or inactive control by searching MEDLINE and Embase, Web of Science to December 2018. There was no language restriction. Two reviewers extracted data on trial characteristics, methods and outcomes. We assessed risk of bias for individual trials (Cochrane tool) and quality of evidence (GRADE checklist). We assessed 109 trials (8561 women) and 12 different methods that resulted in 30 direct comparisons. Methods ranked by OR (95%CI) from most effective to least effective were: metaraminol 0.11 (0.04–0.26); norepinephrine 0.13 (0.06–0.28); phenylephrine 0.18 (0.11–0.29); leg compression 0.25 (0.14–0.43); ephedrine 0.28 (0.18–0.43); colloid given before induction of anaesthesia 0.38 (0.24–0.61); angiotensin 2, 0.12 (0.02–0.75); colloid given after induction of anaesthesia 0.52 (0.30–0.90); mephentermine 0.09 (0.01–1.30); crystalloid given after induction of anaesthesia 0.78 (0.46–1.31); and crystalloid given before induction of anaesthesia 1.16 (0.76–1.79). Phenylephrine caused maternal bradycardia compared with control, OR (95%CI) 0.23 (0.07–0.79). Ephedrine lowered umbilical artery pH more than phenylephrine, standardised mean difference (95%CI) 0.78 (0.47–1.49). We conclude that vasopressors should be given to healthy women to prevent hypotension during caesarean section with spinal anaesthesia.

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Section: Resultsmentioning

confidence: 99%

Prevention of hypotension after spinal anaesthesia for caesarean section: a systematic review and network meta‐analysis of randomised controlled trials

et al. 2019

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“…A 500‐ml pre‐load of 6% hydroxyl‐ethyl starch (HES; 130/0.4) followed by 500 ml Ringer's lactate, in combination with prophylactic boluses of phenylephrine, was associated with a significantly lower incidence of hypotension compared with a 1000‐ml pre‐load of Ringer's lactate (37% vs. 55%, respectively) as well as less symptomatic hypotension (4% vs. 14%, respectively) . In general a 500‐ml pre‐load of colloid appears as effective as a 1000‐ml coload of crystalloid . Thus, both fluid‐loading techniques can be recommended to improve the haemodynamic stability provided by vasopressor prophylaxis.…”

Section: Cardiovascular Changes After Spinal Anaesthesiamentioning

confidence: 99%

International consensus statement on the management of hypotension with vasopressors during caesarean section under spinal anaesthesia

et al. 2017

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Why was this consensus statement developed?Advances in clinical practice are sometimes inhibited by a multitude of different options that need to be selected. There has been significant variation in the treatment of spinal anaesthesia-induced hypotension. These guidelines are designed to provide clinicians with specific best-practice plans that will cover a wide range of drug and equipment availability. Detailed recommendations are provided for the management of hypotension in resource-rich and resource-poor environments.

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“…Most studies reported that co-loading is superior to (or at least the same as) preloading when comparing the two protocols using the same type of fluid. Crystalloid co-loading is superior to crystalloid preloading [16][17][18][19] and similar to colloid preloading [20]. Colloid co-loading is not superior to colloid preloading [21][22][23][24].…”

Section: Co-loadingmentioning

confidence: 99%

“…No difference [25] RCT Crystalloid co-load versus colloid preload No difference [20] RCT Colloid preload versus colloid co-load…”

Section: Protocolmentioning

confidence: 99%

Post-spinal anesthesia hypotension during cesarean delivery, a review article

Hasanin

Mokhtar

Badawy

et al. 2017

Egyptian Journal of Anaesthesia

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a b s t r a c tMaternal hypotension is a common complication after spinal anesthesia for cesarean delivery. Prevention and treatment of post-spinal hypotension (PSH) in cesarean delivery has been frequently investigated.Fluid loading is superior to no-fluid regimen; however, the incidence of PSH is still high with all fluid loading protocols; thus, the use of fluid loading as a sole method for prophylaxis might be not satisfactory for many anesthetists. Phenylephrine is the preferred vasopressor for prevention and management of PSH in most cases. Ephedrine may be more beneficial in patients with bradycardia, patients with uteroplacental insufficiency and pre-eclamptic patients. Norepinephrine infusion was recently investigated as an alternative for prophylaxis of PSH with minimal cardiac side effects.The high incidence of PSH with most of the pharmacological and non-pharmacological methods suggests the need for multimodal protocols for prevention and management of this problem. PSH in cesarean delivery is a common daily situation facing all anesthetists; thus, future research should focus on simple and rapid protocols that can be easily applied by anesthetists with moderate and low experience with minimal need to complex devices or costly drugs.

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Comparison between colloid preload and crystalloid co-load in cesarean section under spinal anesthesia: a randomized controlled trial

Cited by 44 publications

References 33 publications

Prevention of hypotension after spinal anaesthesia for caesarean section: a systematic review and network meta‐analysis of randomised controlled trials

Prevention of hypotension after spinal anaesthesia for caesarean section: a systematic review and network meta‐analysis of randomised controlled trials

International consensus statement on the management of hypotension with vasopressors during caesarean section under spinal anaesthesia

Post-spinal anesthesia hypotension during cesarean delivery, a review article

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