PREVENTION OF SPINAL ANAESTHESIA INDUCED HYPOTENSION IN ELECTIVE CESAREAN SECTION: A COMPARISON OF RINGER LACTATE, PENTASTARCH 6% AND POLYGELATIN 3.5% AS PRELOADING FLUIDS

Abstract

Aim and Objective: To find a safe and effective method for diminishing the incidence and severity of spinal anaesthesia induced hypotension (SAIH) by preloading either with ringer lactate (RL) or pentastarch 6% or polygelatin 3.5%. Method:  A total of 120 parturients of ASA grade II were divided into three equal groups. For preloading, group I parturients received 15ml/kg of RL and group II received 7.5ml/kg of pentastarch 6% and group III received 7.5ml/kg of polygelatin 3.5% over 15 to 20 minutes before initiation of spinal anaesthesia. Results: Subarachnoid block was given at L₂- L₃ or L₃-L₄ with 2 to 2.5 ml of 0.5% bupivaccaine (Heavy). The upper sensory level was tried to maintain between T₄ to T₆. After subarachnoid block, SBP and DBP in all three groups decreased but fall in SBP and DBP in RL group being significantly more than that in pentastarch 6% and polygelatin 3.5% groups. The incidence of hypotension (62%) as well as number of episodes of hypotension (total 35) was more in RL group, therefore vasopressor requirement in this group was maximum (108 mg). Mean time of onset of hypotension in RL group was 6.16 minutes and in group II was 13 minutes and in group III it was 13.2 minutes. Conclusion: The preloading either with pentastarch 6% or polygelatin 3.5% is highly effective and comparable in prevention of SAIH. But risk of allergic reaction with polygelatin 3.5% makes pentastarch 6% better and safer colloid for preloading.