Fluid loading therapy to prevent spinal hypotension in women undergoing elective caesarean section: Network meta-analysis, trial sequential analysis and meta-regression
BACKGROUND
Fluid loading is one of the recognised measures to prevent hypotension due to spinal anaesthesia in women scheduled for a caesarean section.
OBJECTIVE
We aimed to evaluate the current evidence on fluid loading in the prevention of spinal anaesthesia-induced hypotension.
DESIGN
Systematic review and network meta-analysis with trial sequential analysis and meta-regression.
DATA SOURCES
Medline, Epub, Embase.com (Embase and Medline), Cochrane Central, Web of Science and Google Scholar were used.
ELIGIBILITY CRITERIA
Only randomised controlled trials were used. Patients included women undergoing elective caesarean section who received either crystalloid or colloid fluid therapy as a preload or coload. The comparator was a combination of either a different fluid or time of infusion.
RESULTS
A total of 49 studies (4317 patients) were included. Network meta-analysis concluded that colloid coload and preload offered the highest chance of success (97 and 67%, respectively). Conventional meta-analysis showed that crystalloid preload is associated with a significantly higher incidence of maternal hypotension than colloid preload: risk ratio 1.48 (95% CI 1.29 to 1.69, P
Source: European Journal of Anaesthesiology - Category: Anesthesiology Tags: Obstetrics Source Type: research