Year: 2026 | Month: September | Volume: 16 | Issue: 9 | Pages: 1-11
DOI: https://doi.org/10.52403/ijhsr.20260901
Crystalloid Preloading versus Coloading for Prevention of Spinal Anaesthesia Induced Hypotension in Inguinal Hernioplasty
Ambhrin Saha1, Aditi Bhattacharya2, Sourav Saha3, Kangchai Chaudhuri4
1Assistant Professor, Department of Anaesthesiology,
TMC & Dr. BRAM Teaching Hospital, Agartala, Tripura, India.
2Associate Professor, Department of Anaesthesiology,
TMC & Dr. BRAM Teaching Hospital, Agartala, Tripura, India.
3Assistant Professor, Department of Anaesthesiology,
TMC & Dr. BRAM Teaching Hospital, Agartala, Tripura, India.
4Associate Professor, Department of Anaesthesiology,
TMC & Dr. BRAM Teaching Hospital, Agartala, Tripura, India.
Corresponding Author: Dr. Kangchai Chaudhuri
ABSTRACT
Background: Spinal anaesthesia is widely used for inguinal hernioplasty but is frequently complicated by hypotension. Fluid management strategies such as preloading and coloading with crystalloids are employed to mitigate this risk, though their relative efficacy remains debated.
Objective: To compare haemodynamic outcomes and adverse effects of crystalloid preloading versus coloading in patients undergoing inguinal hernioplasty under spinal anaesthesia.
Methods: In this prospective, randomised, double‑blind trial, 120 ASA I–II patients were allocated to receive lactated Ringer’s solution either 20 minutes before (preload group) or immediately after (coload group) spinal anaesthesia. Blood pressure, heart rate, oxygen saturation, incidence of hypotension, and adverse effects were recorded for 20 minutes post‑block.
Results: Demographic variables were comparable between groups. Pulse rate (p=0.65–0.99 across time points) and oxygen saturation (p=0.09–1.00) remained stable. Preloading maintained significantly higher systolic blood pressure at 3 minutes (p=0.02) and 10 minutes (p=0.04), and higher diastolic pressure at 10 minutes (p=0.01) and 15 minutes (p<0.01). Mean arterial pressure was also significantly higher in the preload group immediately after spinal anaesthesia (p=0.06, not significant), at 3 minutes (p=0.01), 10 minutes (p<0.01), and 15 minutes (p<0.01). At 20 minutes, MAP was slightly higher in the coload group (p=0.13). Hypotension occurred in 13.3% of preload patients versus 28.3% of coload patients (p=0.07). Vomiting was the only adverse effect, observed in 18.3% of preload and 13.3% of coload patients (p=0.61). No bradycardia, pulmonary oedema, or desaturation were reported.
Conclusion: Both preload and coload strategies are safe and effective in preventing severe hypotension during spinal anaesthesia. Preloading resulted in higher blood pressure values at selected time points (p<0.05), but this did not translate into a statistically significant reduction in the overall incidence of hypotension.
Key words: Spinal anaesthesia; Inguinal hernioplasty; Crystalloid preload; Crystalloid coload; Hypotension prevention; Haemodynamic stability; Adverse effects