The Effect of Adding 1% Glucose to Crystalloid on Maternal Hemodynamics After Spinal Anesthesia for Cesarean Delivery: A Double-Blind, Randomized Clinical Trial

Abstract

Background: We aimed to evaluate the effect of glucose-containing crystalloid infusion before anesthesia induction on hemodynamics and postanesthesia complications. Methods: This double-blind, randomized clinical trial was conducted on 60 parturient cases scheduled for elective Cesarean delivery under spinal anesthesia who were referred to the teaching hospitals of Mashhad University of Medical Sciences (Iran). The parturients were randomized into two groups. Both groups received 5 - 7 mL/kg of intravenous bolus serum before spinal anesthesia. The parturients in the glucose-containing normal saline (GcNS) group received 1% glucose solution in normal saline. The normal saline (NS) group received only normal saline. Systolic blood pressure (SBP), diastolic blood pressure (DBP), heart rate (HR), blood glucose concentrations, neonatal Apgar scores, postanesthesia complications, and ephedrine and atropine consumption were evaluated. Results: Sixty patients were recruited (30 in each group), with a mean age of 29.14 ± 6.01 and 29.76 ± 6.15 years in the GcNS and NS groups, respectively. There was no significant difference between the two groups in SBP, DBP, or HR after baseline adjustment. The incidence of hypotension was higher in the NS (70.0%) compared to the GcNS group (46.6%), but the difference was not significant. There was no significant difference in Apgar scores. The incidence of nausea, vomiting, pallor, and shivering was higher in the NS group. However, only nausea and vomiting 10 minutes after anesthesia induction were significant. Ephedrine and atropine consumption was higher in the NS group, but not significantly. Conclusions: The present study did not show any clear benefit for adding 1% glucose to normal saline solution preload for hypotension in parturients undergoing Cesarean delivery with spinal anesthesia.