Preload or coload for spinal anesthesia for elective Cesarean delivery: a meta-analysis

Banerjee, A.; Stocche, Renato Mestriner; Angle, Pamela; Halpern, Stephen H.

doi:10.1007/s12630-009-9206-7

Cited by 119 publications

(77 citation statements)

References 26 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…On the other hand, Siddik-Sayyid et al [23] reported non-significantly higher incidence of hypotension (68% vs. 75%) and of severe hypotension (16% vs. 22%) with coloading compared to preloading. On contrary and in support of coloading, Banerjee et al [24] retrieved randomized controlled trials that compared a fluid preload with coload in patients undergoing spinal anesthesia for elective CS and reported non-significantly reduced frequency of hypotension with coloading.…”

Section: Discussionmentioning

confidence: 99%

Role of Incisional infiltration with intraperitoneal instillation analgesia in non descent vaginal hysterectomy

Assar

Elmentawy

Mosaad

et al. 2018

Evidence Based Women's Health Journal

View full text Add to dashboard Cite

Objective: To evaluate therapeutic yield of tranexamic acid (TXA) injection and fluid co-load on the outcome of cesarean section (CS) conducted under spinal anesthesia Study Design : Prospective randomized comparative study. Patients and Methods:The current included 174 primipara scheduled for elective CS under spinal anesthesia. Intravenous (IV) fluid co-load (15 ml/kg warm lactated ringer solution) started as fast drip during and continued after spinal anesthesia. Patients were randomly allocated into two equal groups: Group TXA received a loading IV dose of 500 mg TXA 20 minutes before surgery followed by continuous TXA infusion at rate of 1 mg/kg/min till end of surgery. Group C did not receive prophylactic TXA, but both groups received a booster dose of 2 gm TXA if required. Patients were monitored for the frequency and severity of hypotension and dose of ephedrine used. Amount of bleeding since skin incision till 2-hours postpartum (PP), the frequency of patients had stopped PP bleeding till 2-hr PP and the total dose of oxytocin drugs and booster doses of TXA were recorded. Results: Hypotension was recorded in 53 patients (30.5%); only 12 patients had blood pressure <80 mmHg. The lowest blood pressure, frequency of hypotension, time of occurrence and duration of hypotension and the used dose of ephedrine showed non-significant difference between both studied groups. The amount of perioperative bleeding was significantly lower in TXA group compared to control group. Twenty parturient had continued PP bleeding for more than 2 hours PP with significantly (p=0.038) lower frequency of bleeders in TXA group. All women had continued bleeding received booster doses of TXA with a significantly higher dose in control group compared to TXA group. Conclusion: Preoperative administration of TXA significantly reduced perioperative bleeding with significant reduction of consumption of TXA booster doses and utrotonics without affecting safety. Fluid coloading allowed reduction of the frequency and extent of hypotension concomitant with spinal anesthesia.

show abstract

Section: Discussionmentioning

confidence: 99%

Role of Incisional infiltration with intraperitoneal instillation analgesia in non descent vaginal hysterectomy

Assar

Elmentawy

Mosaad

et al. 2018

Evidence Based Women's Health Journal

View full text Add to dashboard Cite

show abstract

“…However, several studies disapproved the fluid-loading regimen because no significant difference has been found with any given volume of fluid infused 11,16,27 . In Banerjee's systematic review, approximately 60% of patients still developed hypotension in both preloading and coloading regimens 20 . In our study, we observed about 42% of patients experience hypotension and the EV 50 of crystalloid was 13 mL.kg -1 .…”

Section: Discussionmentioning

confidence: 99%

“…Nonetheless, the coloading or postloading regimen has been proposed due to a much more effective role in decreasing the rate of hypotension [9][10][11][12] . However, Banerjee et al 20 reviewed on how the incidence of maternal hypotension in spinal anesthesia is still high -about 60% -regardless the fluid loading strategy used. In addition, neither of the conventional methods of fluid management -wether 'liberal' (2,000 mL per person) or 'restricted' (500 mL per person) -produced ideal effects on preventing hypotension and balancing circulation.…”

Section: Introductionmentioning

confidence: 99%

Volume mediano efetivo de cristaloides na prevenção de hipotensão arterial em pacientes submetidas à cesariana com raquianestesia

Xu¹,

Wu²,

Zhao³

et al. 2012

Rev. Bras. Anestesiol.

View full text Add to dashboard Cite

show abstract

“…Mercier et al 4 showed that loading fluid (coloading) at the time of administering the intrathecal local anesthetic may be a physiologically more appropriate and better approach as the maximal effect of coloading can be achieved during the time of the block. Banerjee et al, 6 in their meta-analysis,…”

Section: Blood Pressure Responsementioning

confidence: 99%

“…5,8 Fluid coloading appears to be more physiological and rational approach as the maximal effect can be achieved at the time of onset of the block. 6 Recently, few studies have been conducted which indicate that coloading may be equally effective as preloading with colloid. 7,8 Central venous pressure monitoring reflects the volume load in the circulatory system.…”

Section: Introductionmentioning

confidence: 99%

Crystalloid Coload vs Colloid Coload following Spinal Anesthesia for Elective Cesarean Delivery: The Effects on Maternal Central Venous Pressure

2017

The Journal of Medical Sciences

View full text Add to dashboard Cite

Introduction: Spinal anesthesia is widely used in the management of uncomplicated cesarean section. Maternal hypotension is the commonest serious problem which decreases uterine blood flow causing fetal hypoxia, acidosis, and neonatal depression. Fluid administration before start of the surgery (preloading) with crystalloid is found to be ineffective due to rapid redistribution of fluids in various tissue spaces. A "coload" given at the time of spinal anesthesia may be more effective. Most studies have concentrated on noninvasive systolic blood pressure (SBP) measurements to evaluate the effect of such regimens. We used central venous pressure (CVP) measurement technique in parturients receiving rapid administration of crystalloid or colloid solution at the time of initiation of anesthesia (coload). We hypothesized that a colloid coload compared with a crystalloid coload would produce a larger sustained increase in volume and therefore reduce vasopressor requirements. Materials and methods:We recruited healthy term women scheduled for elective cesarean delivery under spinal anesthesia for this randomized study. Baseline heart rate, baseline mean arterial blood pressure (MAP), and CVP were recorded. At the time of spinal injection, subjects were allocated to receive a rapid 1 L coload of either polymerized gelatin 3.5% (Haemaccel) or Hartmann (crystalloid) solution. The primary outcome CVP was compared between groups, as were secondary outcomes: phenylephrine dose and maternal hemodynamics data.Results: Maternal demographics, surgical times, and American Society of Anesthesiologists (ASA) were similar between groups. Baseline parameters were similar in all the three groups. Heart rate increased from the baseline in all the three groups; however, mean heart rate was highest in crystalloid group. Mean arterial blood pressure decreased in all the three groups from baseline; however, highest fall was recorded in crystalloid group. The incidence of hypotension was 66.66% in crystalloid group as compared with 36.66% in colloid group. Crystalloid group patients received 6.33 ± 4.54 mg of ephedrine as compared with 2.40 ± 2.82 mg in colloid group. Thus, the incidence of hypotension and ephedrine consumption was significantly higher in crystalloid group as compared with colloid group. We found statistically significant differences in the mean preoperative CVP reading (p < 0.05) between the two groups, the mean CVP reading in crystalloid group being slightly lower. With preloading, similar CVP readings were obtained in both groups. The fall in CVP during subarachnoid blockade was also not significant. The CVP began to fall with the establishment of the block until the delivery of the baby after which it was found to rise. The predelivery CVP was significantly lower than preoperative CVP in both groups-the fall being significantly more in crystalloid group. Conclusion:In our study, the results showed statistically significant decrease in volume requirement, when colloid coload is used than crystalloid coload using C...

show abstract

Preload or coload for spinal anesthesia for elective Cesarean delivery: a meta-analysis

Cited by 119 publications

References 26 publications

Role of Incisional infiltration with intraperitoneal instillation analgesia in non descent vaginal hysterectomy

Role of Incisional infiltration with intraperitoneal instillation analgesia in non descent vaginal hysterectomy

Volume mediano efetivo de cristaloides na prevenção de hipotensão arterial em pacientes submetidas à cesariana com raquianestesia

Crystalloid Coload vs Colloid Coload following Spinal Anesthesia for Elective Cesarean Delivery: The Effects on Maternal Central Venous Pressure

Contact Info

Product

Resources

About