Preoperative dextrose does not affect spinal-induced hypotension in elective Cesarean section.
OBJECTIVE
To determine if preoperative intravenous dextrose affects the incidence and ease of treatment of spinal-induced hypotension in parturients having elective Cesarean section under spinal anesthesia.


METHODS
In this prospective, double-blind study, following informed consent, 119 ASA I, II parturients for elective Cesarean section were randomized to receive intravenously either dextrose 5% in normal saline (Group D) or normal saline (Group NS) at 125 ml x hr(-1) for two hours prior to delivery. Following a bolus of 15 ml x kg(-1) normal saline iv, spinal anesthesia was induced with hyperbaric bupivacaine 0.75%, fentanyl and morphine. Hypotension (systolic blood pressure <100 mm Hg or >20% decrease) was treated with fluids and/or vasopressor.


METHODS
demographics, blood glucose concentrations (fasting, time of spinal, delivery), blood pressure (baseline, one minute intervals from spinal to delivery), neonatal Apgar scores, umbilical blood gas analyses, glucose and lactate concentrations.


RESULTS
There was no difference between the two groups in the rate of hypotension (P = 0.272). All parturients who experienced hypotension received fluids, and there was also no difference between the groups in vasopressor requirement [mean dose of ephedrine: Group D = 21.6 mg (95% CI 15.1-28.2), Group NS = 16 mg (95% CI 12.0-20.5)].


CONCLUSIONS
The routine administration of dextrose 5% at a rate of 5.22 g x hr(-1) preoperatively does not affect the hypotension rate, or make it easier to treat.
Wilson
D
D
Department of Anaesthesia, BC Women's Hospital and Health Centre, Vancouver, Canada.
Douglas
J
J
Heid
R
R
Rurak
D
D
D000328:Adult; D000773:Anesthesia, Obstetrical / Q000009:adverse effects*; D000775:Anesthesia, Spinal / Q000009:adverse effects*; D001786:Blood Glucose / Q000032:analysis; D002585:Cesarean Section; D004311:Double-Blind Method; D005260:Female; D005947:Glucose / Q000494:pharmacology*; D006801:Humans; D007003:Hypoglycemia / Q000209:etiology; D007022:Hypotension / Q000209:etiology / Q000517:prevention & control*; D007231:Infant, Newborn; D011247:Pregnancy; D011446:Prospective Studies
D001786:Blood Glucose; D005947:Glucose