Comparison of Intravenous Versus Oral Fluid for Prophylaxis of Maternal Hypotension During Cesarean Section Under Spinal Anesthesia

Abstract

Objective: To assess the effectiveness of oral versus intravenous fluid for prophylaxis of maternal hypotension after spinal anesthesia for elective cesarean section.

Methodology: Departments of Anesthesiology and Gynecology & Obstetrics, Rahat Hospital Karachi for 08 months from 1st March 2023 to 31th October, 2023. After the approval of hospital ethical committee, 120 patient (n=60) undergoing elective cesarean section were divided into two groups by lottery method. Group A were 300ml oral potable water given; whereas group B were given 10 ml/kg intravenous Lactated Ringer’s solution at 2-4 hours preoperatively. Our primary outcomes were: frequency of maternal hypotension. The secondary outcomes were: intra-operative changes in blood pressure, heart rate and interventions required for treatment of maternal hypotension. SPSS version 23 was used to data analysis.

Results: A total of 120 (n=60 in each group) patient had at least one episode of hypotension. Both oral and intravenous fluid was effective in preventing hypotension 5 (8.3%) versus 2 (3.3%); p=0.439. 5 (8.3%) required rescue phenylephrine bolus to treat hypotension; p=0.923. 7 (11.6%) patient complaints of nausea in group A versus 2 (3.3%) in group B; p=0.323. The systolic and diastolic blood pressure as well as heart rate remained comparable till 60 minutes; p-value> 0.05

Conclusion: Oral and intravenous fluid given at 02-04 pre-operatively in elective cesarean section were comparable in regards to prevention of maternal hypotension under spinal anesthesia.