Is crystalloid co-loading necessary to prevent spinal hypotension during elective cesarean delivery? A randomized double-blind trial
Authors' conclusion
Omission of crystalloid co-loading leads to a decrease in cardiac output which has a potentially unfavorable impact on neonatal acid base status.
Study context
- Population
- Term pregnant women scheduled for elective cesarean delivery under spinal anaesthesia with phenylephrine titrated to maintain BPanalysed
- Participants
- 63 women
- Comparison
- No loading vs Co-loading
- Primary endpoint
- Changes in CO following spinal anaesthesia
Methodological detailsdouble-blind, non-inferiority
- Double-blind
- Non-inferiority
Primary result
As reported in the abstract
Increase in CO
Ratio
0.67
95% CI 0.15–1.36
33% less increase in CO with no loading
Ratio
1.6
95% CI 1.0–2.7
reduction of CO: 60% greater with no loading
Secondary outcomes
Total dose of phenylephrine
- Higher in the no-loading group
Neonatal acid base status
- Possibly less favorable without volume loading
Original publication
Is crystalloid co-loading necessary to prevent spinal hypotension during elective cesarean delivery? A randomized double-blind trial. Int J Obstet Anesth. Published 13 December 2023. doi:10.
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