PREVENTION OF HYPOTENTION AFTER SPINAL ANAESTHESIA IN ELECTIVE CAESAREAN SECTIONS.

Objective: Comparing the efficacy of crystalloid pre-load and co-load on reducing hypotension and improving APGAR score in patients receiving spinal anaesthesia for elective caesarean sections. Study Design: Randomized controlled study. Place and Duration of Study: This study was carried out at Combined Military Hospital Bahawalpur, after seeking permission from ethics committee. The data was collected for 06 months from Jan to Jul 2017. Methodology: Patients with ASA classification 1 and 2, aged 18-40 years were included. Group A received 15ml/kg Hartmann’s solution as preloading solution in 15 minutes before the induction of spinal anaesthesia. Group B received 15ml/kg of Hartmann’s solution as co-loading solution after performing a block in 15min. Results: This study includes 314 patients (157 in each group). Our study population was slightly predominated by females 170 (54%) as compared to 144 (46%) males. The average Apgar score in both groups were 9.8 ± 0.58 and 9.7 ± 0.436. Out of 314 patients, 169 patients (54%) were ASA I and remaining 46% were ASA II. Overall hypotention was noted in 67 patients (21.3%) of group A and 30 patients (9.6%) of group B. The difference between two groups was statistically significant (p=0.001*). Improving Apgar score was noted in 54 patients (17.2%) of group-A and 117 patients (37.3%) of group-B. The difference between two groups was statistically significant (p=0.001*). Conclusion: It is concluded that co-load is better than pre-load in reducing hypotension and improving Apgar score in patients receiving spinal anaesthesia for elective caesarean sections. [ABSTRACT FROM AUTHOR]