TO COMPARE THE EFFECTIVENESS OF SEQUENTIAL COMPRESSION DEVICE VS CRYSTALLOID PRELOAD IN REDUCING POST SPINAL HYPOTENSION IN CAESAREAN SECTION

Abstract

Background: Spinal anaesthesia (SA) is a standard technique for caesarean sections, but it commonly induces hypotension, which is defined as a systolic blood pressure (SBP) drop of over 20% from baseline or an SBP below 90 mmHg. This hypotension, resulting from venous pooling due to sympathetic blockade and progesterone-induced vascular tone reduction, is observed in 80-83% of cases and poses risks to both mother and foetus. Effective management strategies include intravenous fluid preload and sequential compression devices (SCDs), yet comparative data on their efficacy remain sparse. This study aims at comparing the effectiveness of Sequential Compression Devices (SCDs) versus Crystalloid Preload in reducing post-spinal hypotension during caesarean sections. Materials and Methods: A randomized controlled study was conducted on 60 patients undergoing elective caesarean sections at R.L. Jalappa Hospital and Research Centre, Kolar”. Patients were randomised to the Crystalloid group (n = 30) or the SCD group (n = 30). Group C received a Ringer Lactate preload (10 ml/kg over 10 minutes), while Group S used SCDs (compression at 60 mmHg) prior to spinal block. Parameters monitored included heart rate, systolic and diastolic blood pressure, and the need for additional treatments. Data were analyzed using SPSS v23.0, with a p-value <0.05 deemed statistically significant. Results: The mean age of participants was 26.8 ± 3.5 years, with nil significant age differences between the groups. Heart rate changes also showed no differences between the two groups. Systolic blood pressure (SBP) dropped significantly from the 6th to 12th minute in the Crystalloid group compared to the SCD group (p < 0.05). Diastolic blood pressure (DBP) was significantly lower in the SCD group at the 55th and 60th minutes post-intervention (p < 0.05). The Crystalloid group required significantly more additional treatments at the 6th minute (p < 0.05). xvi Conclusion: Sequential Compression Devices (SCDs) are more effective than Crystalloid Preload in mitigating early post-spinal hypotension during caesarean sections. SCDs provide superior stability of systolic blood pressure and reduce the need for additional treatments shortly after anaesthesia administration, making them a preferable option in managing post-spinal hypotension in caesarean sections.