Co-Loading Versus Pre-Loading for Preventing Post-Spinal Hypotension in Caesarean Section


  • Muhammad Tayyab Saeed Department of Anaesthesia, Combined Military Hospital, Quetta/National University of Medical Sciences (NUMS) Pakistan
  • Ali Rao Department of Anaesthesia, Combined Military Hospital, Multan/ National University of Medical Sciences (NUMS) Pakistan
  • Muhammad Nasir Saeed Department of Anaesthesia, Allied Hospital, Faisalabad Pakistan
  • Tasneem Alam Department of Anaesthesia, Combined Military Hospital, Quetta/National University of Medical Sciences (NUMS) Pakistan
  • Azmat Riaz Department of Anaesthesia, Pak Emirates Military Hospital/National University of Medical Sciences (NUMS) Rawalpindi Pakistan
  • Hira Ahmad Department of Anaesthesia, Tehsil Headquarter Hospital, Gujar Khan Pakistan



Co-loading, Leg Elevation, Post-Spinal Hypotension, Pre-loading


Objective: To compare the frequency of post-spinal anaesthesia hypotension occurring with co-loading versus pre-loading in patients undergoing caesarean section.

Study Design: Cross-sectional analytical study.

Place and Duration of Study: Department of Anaesthesiology, Pak-Emirates Military Hospital, Rawalpindi Pakistan, Sep 2020 to Mar 2021.

Methodology: A total of 70 patients undergoing spinal anaesthesia for caesarean section and meeting the sample selection criteria were included. Patients with emergency procedures or a history of blood pressure disorders were excluded. Patients in Group-A underwent co-loading with ringer lactate, while patients in Group-B underwent pre-loading. All participants had their systolic and diastolic blood pressure and mean arterial pressure measured at the time of anaesthesia induction and then at 5, 10, 15, and 30 minutes post anaesthesia induction.

Results: There was difference in mean systolic pressure at 10 and 15 minutes, p=0.001 and p=0.027, respectively. The difference in diastolic blood pressure was only significant at 10 minutes, p=0.001. While, mean arterial pressures were significantly higher at 10 and 15 minutes with co-loading, p<0.001 and p=0.019, respectively.
Conclusion: Co-loading is associated with less frequency of post-spinal hypotension than pre-loading and may be employed as a standard practice pre-operatively with spinal anaesthesia.


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How to Cite

Saeed MT, Ali Rao, Muhammad Nasir Saeed, Tasneem Alam, Azmat Riaz, Hira Ahmad. Co-Loading Versus Pre-Loading for Preventing Post-Spinal Hypotension in Caesarean Section. Pak Armed Forces Med J [Internet]. 2024 Apr. 29 [cited 2024 May 24];74(2):401-4. Available from:



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