title: Preload Versus Coload and Vasopressor Requirement for the Prevention of Spinal Anesthesia Induced Hypotension in Non-Obstetric Patients.
abstract: OBJECTIVE
  To compare the effectiveness of preload and coload for the prevention of Spinal Induced Hypotension (SIH) and vasopressor requirements.
  
  
  METHODS
  Randomized trial.
  
  
  METHODS
  Department of Anesthesia, The Aga Khan University Hospital, Karachi, Pakistan, from June 2007 - June 2010.
  
  
  METHODS
  Sixty patients were randomly divided into preload and coload group of 30 each. Patients with ASA1 - 3, aged 20 - 60 years were included. Patients with history of IHD, COPD, BMI > 30 and surgical procedure TURPwere excluded. All patients received crystalloid 10 ml/kg before induction of spinal anesthesia in preload group and at the time of spinal anesthesia in coload group. Blood pressure and heart rate were recorded at different time intervals till 45 minutes. Patients received ephedrine 5 mg when systolic blood pressure dropped below 90 mmHg and heart rate was less than 60 beats/minute and/or phenylephrine 50 micrograms when systolic blood pressure dropped below 90 mmHg and heart rate was more than 60 beats/minute.
  
  
  RESULTS
  There was no statistically significant difference at different time intervals in heart rate, systolic and mean arterial pressure between the groups. Diastolic blood pressure was significantly different in both groups at 6 - 15 minutes after spinal anesthesia. SIH occurred (21) 70% and (15) 50% in preload and coload groups, respectively (p = 0.187). Ephedrine requirement for SIH was significantly high in preload group (p = 0.017). Phenylephrine requirement for SIH was high in preload group which was statistically non-significant (p = 0.285).
  
  
  CONCLUSIONS
  Coload group has lower incidence of spinal induced hypotension and significantly less vasopressor requirement than the preload group.
authors.affiliation: Department of Anesthesia, College of Medicine, King Saud University, Riyadh, Saudi Arabia.
authors.forename: Mueen Ullah
authors.initials: MU
authors.lastname: Khan
authors.affiliation: Department of Anesthesia, Northern Area Armed Forces Hospital, King Khalid Military City, Hafr Al Batin, Saudi Arabia.
authors.forename: Abdul Saboor
authors.initials: AS
authors.lastname: Memon
authors.affiliation: Department of Anesthesia, Shalamar Hospital, Shalamar Road, Lahore, Pakistan.
authors.forename: Mohammad
authors.initials: M
authors.lastname: Ishaq
authors.affiliation: Department of Anesthesia, College of Medicine, King Saud University, Riyadh, Saudi Arabia.
authors.forename: Mansoor
authors.initials: M
authors.lastname: Aqil
mesh_terms: D000328:Adult; D000775:Anesthesia, Spinal / Q000009:adverse effects / Q000379:methods*; D001794:Blood Pressure / Q000187:drug effects*; D003102:Colloids / Q000008:administration & dosage*; D004809:Ephedrine / Q000008:administration & dosage; D005260:Female; D006801:Humans; D007022:Hypotension / Q000209:etiology / Q000503:physiopathology / Q000517:prevention & control*; D008297:Male; D008875:Middle Aged; D013997:Time Factors; D016896:Treatment Outcome; D014662:Vasoconstrictor Agents / Q000008:administration & dosage
chemical_list: D003102:Colloids; D014662:Vasoconstrictor Agents; D004809:Ephedrine