title: Combined use of crystalloid preload and low dose spinal anesthesia for preventing hypotension in spinal anesthesia for cesarean delivery: a randomized controlled trial.
abstract: OBJECTIVE
  Spinal anaesthesia for caesarean section is commonly associated with hypotension and crystalloid preload is widely recommended. Low-dose spinal appears to cause less hypotension. The aim of this study was to investigate whether the combined use of crystalloid preload and low dose spinal anaesthesia might further reduce the rates of hypotension.
  
  
  METHODS
  Sixty-two patients were randomly assigned to two groups: crystalloid preload anaesthesia (P): received a rapid infusion of 20 mL/kg lactated Ringer's solution (LR), and no preload anaesthesia (N). The incidence of hypotension and the amount of ephedrine used to treat it were compared. Spinal anaesthesia was performed with 0.5% isobaric bupivacaine 7.5 mg and fentanyl 10 microg and morphine 100 microg.
  
  
  RESULTS
  The incidence of hypotension was similar in the P and N groups. Same doses of ephedrine were required to treat hypotension in the two groups.
  
  
  CONCLUSIONS
  Crystalloid preload combined with low-dose spinal anaesthesia do not reduce the incidence of hypotension nor its severity.
authors.affiliation: Department of Thoracic Surgery, Abderrahmen Mami Hospital, Ariana, Tunisia.
authors.forename: Sonia
authors.initials: S
authors.lastname: Ouerghi
authors.forename: Mohamed A
authors.initials: MA
authors.lastname: Bougacha
authors.forename: Nabil
authors.initials: N
authors.lastname: Frikha
authors.forename: Taher
authors.initials: T
authors.lastname: Mestiri
authors.forename: Mohamed S
authors.initials: MS
authors.lastname: Ben Ammar
authors.forename: Mhamed S
authors.initials: MS
authors.lastname: Mebazaa
mesh_terms: D000328:Adult; D000773:Anesthesia, Obstetrical / Q000009:adverse effects*; D000775:Anesthesia, Spinal / Q000009:adverse effects*; D002045:Bupivacaine / Q000008:administration & dosage; D002585:Cesarean Section; D000077324:Crystalloid Solutions; D005260:Female; D006801:Humans; D007022:Hypotension / Q000517:prevention & control*; D007552:Isotonic Solutions / Q000008:administration & dosage*; D011247:Pregnancy
chemical_list: D000077324:Crystalloid Solutions; D007552:Isotonic Solutions; D002045:Bupivacaine