Javed Iqbal Khan, Ateeq Afzal Malik, Tahir Iqbal Khan, Nazia Suleman, Usman Ghani, Mehwish Naz.
Comparison of efficacy of colloid pre-load versus combination co-load in prevention of hypotension during spinal anesthesia for elective inguinal hernia repair.
Pak J Surg Jan ;37(2):123-6.

Introduction: Hypotension following spinal anesthesia occurs due to sympathetic blockade which leads to decreased venous return and cardiac output. Various methods to prevent it are used in surgical patients. This randomized controlled study was done to compare the efficacy of colloid pre load versus combination co-load in prevention of hypotension during spinal anesthesia for elective inguinal hernia repair in Department of Anesthesia and General Surgery at DHQ Teaching Hospital, Haripur. Objective: To determine efficacy of colloid pre-load versus combination co-load in prevention of hypotension during spinal anesthesia for elective inguinal hernia repair. Settings: Department of surgery and anaesthesia DHQ Teaching Hospital, Haripur. Study design: Randomized controlled study Duration: Six months from 1st August 2018 to 31st January 2019. Material and Methods: In this study, 96 patients needing elective inguinal hernia repair were included. Inclusion and exclusion criteria were applied. Patients were randomly assigned into 2 groups by blocked randomization of 48 each. Colloid pre-load group received 500ml of 6% penta starch and combination co-load group received 250ml of 6%penta starch and 750ml of Ringer`s lactate solution. Subarachnoid block with 2ml of .75% heavy bupivacaine was given and blood pressure was monitored till end of surgery. Hypotension was taken as systolic blood pressure <80% of baseline at two different occasions. It was treated with 50 micrograms of aliquots of phenylephrine. Results: Age range was from 18 to 35 years with mean age of 28.708+-2.86 years in colloid preload group while 27.750+-3.07 in combination co-load group. Mean weight was 73.291+-9.70 kilograms in colloid pre load group and 77.875+-7.09 in combination co-load group. Efficacy was 5(10.4%) patients in colloid pre load group as compared to 17(35.4%) patients in combination co-load group(p=.003). Conclusion: Incidence of hypotension was better reduced by crystalloid co-load combination compared to colloid preload over a hydration period of 15 minutes.

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