Fluid Management in Cesarean Section with Spinal Anesthesia: A Retrospective Study

Abstract

Introduction:Spinal anesthesia is a widely used and preferred method for elective cesarean section operations. However, one of the critical side effects is hypotension. In this study, we aimed to compare the effects of fluid replacement preferences on hemodynamics in elective cesarean sections by retrospectively examining the patient files.Methods:We retrospectively searched the anesthesia files dated between 01.11.2017 and 31.10.2018, and reviewed elective cesarean section data undergoing spinal anesthesia. Hemodynamic parameters, fluid replacement, ephedrine use, need for additional medication, nausea, and vomiting were recorded. Patients were divided into two groups as crystalloid group (group C) and crystalloid + colloid group (group CC).Results:Compared to baseline, systolic arterial pressure (SAP), diastolic arterial pressure (DAP), and mean arterial pressure (MAP) values were significantly lower in both groups after spinal anesthesia. SAP, DAP, and MAP values were significantly lower in group C at the 3rd and 6th minutes compared to group CC. Total ephedrine dose was significantly higher in group C, and the number of patients receiving ephedrine was significantly higher in group C.Conclusion:We suggest that co-administration of crystalloid and colloid is more effective than colloid alone in preventing hypotension in patients undergoing spinal anesthesia in elective cesarean section and that it may prevent complications due to high dose fluid replacement.

Keywords

• spinal anesthesia
• hypotension
• fluid replacement