Tiruneh, Abebe (2017) Prospective Cohort Study on Effect of Timinig on Fluid Administration for Prevention of Spinal Anesthesia Induced Hypotension in Obstetric Mothers at Ghandi Memorial Hospital, December 2016 to February 2017 Aaddis Ababa, Ethiopia. Masters thesis, Addis Ababa University.
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Abstract
Introduction: Neuraxial anesthesia remains the preferred choice for Cesarean deliveries across the world. Hypotension is the physiologic consequence of spinal anesthesia and can have a potentially deleterious maternal and fetal impact. Measures to decrease the incidence and severity of maternal hypotension include left uterine displacement, fluid preload, fluid co-load, prophylactic vasoconstrictors, trendelen burg position and leg elevation. Acute hydration has become the cornerstone of prophylaxis of hypotension in obstetrics previously but recently studies showed that co-loading also may be better option in prevention of spinal induced hypotension. Objective: To compare crystalloid preload and coload for the prevention of maternal hypotension in pregnant mothers undergoing elective cesarean section under spinal anesthesia. Secondary outcomes studied included requirement of vasssopressor for treatment of hypotension, maternal nausea and vomiting and neonatal APGAR scores. Materials and Methods: Prospective cohort study design;96 parturients, American Society of Anesthesiologist (ASA) physical status 1 or 2, with uncomplicated pregnancies scheduled for cesarean section under spinal anesthesia were involved into two groups. The preload group takes fluid over 20 min before the placement of spinal block; while the coload group received fluid rapidly starting as soon as CSF was tapped. Independent sample t test, Chi-square test or fisher exact test were used and p value <0.05 considered as statistically significant. Results: The number of mothers who develop hypotension in preload group and Coload group was 39 and 17 respectively and which was statistically significant. Incidence of nausea vomiting was higher in preload group than coload group 25/48 (52%) VS 13/48 (27 %) respectively (x2 =6.27,RR=1.65 ,95%CI1.24-6.86) .Neonatal wt and APGAR score at 1 and 5 minute are comparable and there is no statistically significant difference between the groups. Conclusions: Even if both techniques were in effective in the prevention of spinal-induced maternal hypotension, coloading was better than preloading in the prevention of hypotension after spinal anesthesia. Therefore it is unnecessary to delay surgery in order to deliver a preload of fluid before spinal anesthesia.
| Item Type: | Thesis (Masters) |
|---|---|
| Subjects: | Q Science > Q Science (General) |
| Divisions: | Africana |
| Depositing User: | Vincent Mpoza |
| Date Deposited: | 01 Oct 2018 12:26 |
| Last Modified: | 01 Oct 2018 12:26 |
| URI: | http://thesisbank.jhia.ac.ke/id/eprint/5805 |
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