Phenylephrine infusion for spinal-induced hypotension in elective cesarean delivery: Does preload make a difference?


Journal Article

BACKGROUND AND AIMS: Patients undergoing elective cesarean delivery (CD) have a high-risk of spinal-induced hypotension (SIH). We hypothesized that a colloid preload would further reduce SIH when compared with a crystalloid preload. MATERIAL AND METHODS: Eighty-two healthy parturients undergoing elective CD were included in the study. Patients were randomly assigned to two groups (41 patients in each group) to receive either Lactated Ringer's solution (1500 ml) or hydroxyethyl starch (6% in normal saline, 500 ml) 30 min prior to placement of spinal anesthesia. All patients were treated with a phenylephrine infusion (100 mcg/min), titrated during the study. RESULTS: There was no statistical difference between groups with regards to the incidence of hypotension (10.8% in the colloid group vs. 27.0% in the crystalloid group, P = 0.12). There was also no difference between groups with respect to bradycardia, APGAR scores, and nausea and vomiting. Significantly less phenylephrine (1077.5 ± 514 mcg) was used in the colloid group than the crystalloid group (1477 ± 591 mcg, P = 0.003). CONCLUSION: The preload with 6% of hydroxyethyl starch before CD might be beneficial for the prevention of SIH.

Full Text

Duke Authors

Cited Authors

  • Bottiger, BA; Bezinover, DS; Mets, B; Dalal, PG; Prozesky, J; Ural, S; Vaida, S

Published Date

  • July 2016

Published In

Volume / Issue

  • 32 / 3

Start / End Page

  • 319 - 324

PubMed ID

  • 27625478

Pubmed Central ID

  • 27625478

International Standard Serial Number (ISSN)

  • 0970-9185

Digital Object Identifier (DOI)

  • 10.4103/0970-9185.168159


  • eng

Conference Location

  • India