Preoperative dextrose does not affect spinal-induced hypotension in elective Cesarean section

Purpose: To determine if preoperative intravenous dextrose affects the inci dence and ease of treatment of spinal-induced hypotension in parturients ha ving elective Cesarean section under spinal anesthesia, Methods: In this prospective, double-blind study following informed consent , 119 ASA I, II parturients for elective Cesarean section were randomized t o receive intravenously either dextrose 5% in normal saline (Group D) or no rmal saline (Group NS) at 125 ml.hr(-1) for two hours prior to delivery. Fo llowing a bolus of 15 ml.kg(-1) normal saline iv, spinal anesthesia was ind uced with hyperbaric bupivacaine 0.75%, fentanyl and morphine, Hypotension (systolic blood pressure < 100 mm Hg or > 20% decrease) was treated with fl uids and/or vasopressor. Data collected: demographics, blood glucose concen trations (fasting, time of spinal, delivery), blood pressure (baseline, one minute intervals from spinal to delivery), neonatal Apgar scores, umbilica l blood gas analyses, glucose and lactate concentrations. Results: There was no difference between the two groups in the rate of hypo tension (P = 0.272). All parturients who experienced hypotension received f luids, and there was also no difference between the groups in vasopressor r equirement [mean dose of ephedrine: Group D = 21.6 mg (95% CI 15. 1-28.2), Group NS = 16 mg (95% CI 12.0-20.5)]. Conclusion: The routine administration of dextrose 5% at a rate of 5.22 g.h r(-1) preoperatively does not affect the hypotension rate, or make it easie r to treat.