Clinical evaluation of preloading alone, vasoconstrictors alone and combined prophylaxis for hypotension during subarachnoid block

Background: The most common serious problem associated with spinal anaesthesia remains rapid onset of profound hypotension. Even a mild drop in blood pressure must be avoided in high-risk patients in whom the autoregulatory mechanism may be abnormal. The present study was undertaken to clinically evaluate the efficacy of pre-loading vasoconstrictors (Ephedrine) and combined preloading and vasoconstrictors prophylaxis for hypotension during sub arachnoid block. Aim: The clinical evaluation of preloading alone, vasoconstrictors alone and combined Prophylaxis for hypotension during subarachnoid block. Materials and methods: This is an observational study, approved by the institutional ethical committee. An individual informed consent was taken from all patients selected for the study. All patients belonging to ASA grade 1 and 2, between the age group of 18 to 50 years posted for elective surgeries with SUB ARACHNOID BLOCKS. Patients having coagulation disorders, Cardiac diseases, Patients refusal are excluded. Total 150 patients undergoing elective surgeries with sub arachnoid blocks are included. They were divided into Crystalloid group(50 Patients),Vasoconstrictor group(50 Patients),Combination group(50 Patients). Discussion: Hypotension during subarachnoid block is common. Pre-block crystalloid administration has been recommended by some to reduce the incidence of hypotension. Use of Ephedrine may be an alternative approach. The present study is based on effect of crystalloid preloading and use of vasopressor (Ephedrine) for the prevention of spinal hypotension. Conclusion: Combined use of crystalloid preloading and vasoconstrictor (Ephedrine) is effective in reducing incidence, severity and duration of hypotension due to SAB